Early changes in local hemostasis activation following percutaneous coronary intervention in stable angina patients: a comparison between drug-eluting and bare metal stents |
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Authors: | Ailiman Mahemuti Nicolas Meneveau Marie-France Seronde Francois Schiele Vincent Descotes-Genon Fiona Ecarnot Marie-Cecile Blonde Mariette Mercier Evelyne Racadot Jean-Pierre Bassand |
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Institution: | Department of Cardiology and UPRES EA3920-IFR133, University Hospital Jean-Minjoz, University of Franche-Comté Medical School, Besancon, France. |
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Abstract: | Background Early change in local intracoronary hemostasis following drug-eluting (DES) and bare metal stent (BMS) implantation has never
been assessed in stable angina patients. Methods Markers of local platelet activation (soluble glycoprotein V sGPV] and P-Selectin CD62P]), coagulation activation (tissue
factor TF], prothrombin fragments 1 + 2 F1 + 2] and activated factor VII FVIIa]) and fibrinolysis markers (D-dimers DD],
fibrinogen FIB], tissue plasminogen activator t-PA], and plasminogen activator inhibitor type-1 complexes PAI-1]) were
determined in 20 patients with stable angina who underwent percutaneous coronary intervention (PCI). All patients were pretreated
with clopidogrel, aspirin, and enoxaparin. Systematic balloon predilation was performed before DES (9 patients) and BMS (11
patients) implantation. All blood samples were drawn 10–20 mm distal to the lesion site. Results No significant changes in levels of platelet activation markers occurred during PCI. There was a transient significant increase
in TF (14%; P = 0.004), in F1 + 2 (40%; P = 0.001), and FVIIa (31%; P = 0.007) following angioplasty. Similarly, a significant 43% increase was observed in DD levels following balloon predilation,
associated with an increase of 46%, 60%, and 70% in FIB, t-PA and PAI-1 levels, respectively (all P < 0.0001). All these markers returned to baseline values after stent implantation. No difference was observed between DES
and BMS. Conclusions Early changes in local hemostasis activation following PCI, were related to balloon predilation. Neither DES nor BMS increased
markers of platelet activation, coagulation, or fibrinolysis, under dual antiplatelet and anticoagulant pretreatment. |
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