Published Online
on September 15, 2003

A more recent version of this article appeared on September 30, 2003

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Submitted on July 2, 2002
Revised on July 15, 2003
Accepted on July 15, 2003

Elevated Whole-Blood Tissue Factor Procoagulant Activity as a Marker of Restenosis After Percutaneous Transluminal Coronary Angioplasty and Stent Implantation

Eralp Tutar MD^*, Muhit Ozcan MD, Mustafa Kilickap MD, Sadi Gülec MD, Omer Aras MD, Gulgun Pamir MD, Dervis Oral MD, Luke Dandelet , and Nigel S. Key MD

From the Departments of Cardiology (E.T., M.K., S.G., G.P., D.O.) and Hematology (M.O.), Ankara University School of Medicine, Ankara, Turkey; and Department of Medicine (O.A., L.D., N.S.K.), Division of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, Minneapolis, Minn.

^* To whom correspondence should be addressed. E-mail: tutar{at}dialup.ankara.edu.tr.

Background--Experimental data suggest that tissue factor (TF) may induce neointimal hyperplasia after arterial injury. In this study, we investigated the hypothesis that elevated levels of TF in the circulation contribute to the development of restenosis after percutaneous transluminal coronary angioplasty (PTCA) or stent implantation.

Methods and Results--Whole-blood TF procoagulant activity (TF-PCA) was measured using a previously described assay before, at 3 hours after, and at 24 hours after the intervention in 61 patients with stable angina undergoing PTCA (n=20) or stent implantation (n=41). Coronary angiography was performed 4 to 6 months after the intervention, and luminal narrowing 50% was defined as restenosis. Whole-blood TF-PCA levels did not correlate with intracellular monocyte tumor necrosis factor- expression, a marker of activation of these cells. Baseline levels and time course of whole-blood TF-PCA after the intervention were compared in patients who did or did not subsequently develop restenosis. Whole-blood TF-PCA levels did not change significantly in the 24 hours after either intervention. However, in both the PTCA and stent groups, initial TF-PCA was significantly higher in patients who subsequently developed restenosis (P=0.018 and 0.039 compared with those who did not develop restenosis for PTCA and stent groups, respectively).

Conclusions--Higher baseline values of whole-blood TF-PCA may be a predictor of restenosis after PTCA and stent implantation.

Key words: angina • angioplasty • stents • restenosis

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