The amount of fibrinogen-positive platelets predicts the occurrence of in-stent restenosis

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• 作者：Markus Jaster ; Dieter Horstkotte ; Tobias Willich ; Caroline Stellbaum ; Wulf Knie ; Sebastian Spencker ; Mathias Pauschinger ; Heinz-Peter Schultheiss ; Ursula Rauch
• 关键词：Fibrinogen ; In-stent restenosis ; IVUS ; Acute myocardial infarction ; Thrombocytes ; Neointima proliferation
• 刊名：Atherosclerosis
• 出版年：2008
• 出版时间：March 2008
• 年：2008
• 卷：197
• 期：1
• 页码：190-196
• 全文大小：404 K

文摘

To determine the value of fibrinogen-positive platelet-analysis in predicting restenosis after stent implantation in acute myocardial infarction patients.

Methods and results

Our patient population comprised 50 patients who underwent intravascular ultrasound (IVUS) guided stent implantation for acute myocardial infarction. In all cases, IVUS confirmed a deep vessel wall injury due to a ruptured plaque within the culprit lesion. Flow cytometry quantified the amount of platelets with surface-bound fibrinogen and thrombospondin before and immediately after the intervention. After 5 months, IVUS was repeated to assess the long-term results. In-stent restenosis – defined as a percent diameter stenosis of >50 % – was detected in 11 of 45 patients who attended follow-up angiography. The amount of fibrinogen-positive platelets was significantly higher among patients who subsequently developed in-stent restenosis (50.5 ± 6.8 % fibrinogen-positive platelets immediately after intervention) than among those who did not (39.7 ± 12.3 % fibrinogen-positive platelets, p < 0.005). Receiver operating characteristic curve revealed a 40 % cut-off for fibrinogen-positive platelets immediately after the intervention to predict restenosis (p < 0.05, sensitivity: 90.9 % , specificity: 47.1 % ).

Conclusion

The amount of fibrinogen-positive platelets immediately after stent implantation predicts the occurrence of in-stent restenosis, as confirmed by IVUS in acute myocardial infarction patients.