Altered Plasma Fibrin Clot Properties Are Associated With In-Stent Thrombosis

作者：Undas Anetta^*; Zalewski Jaroslaw; Krochin Marek; Siudak Zbigniew; Sadowski Marcin; Pregowski Jerzy; Dudek Dariusz; Janion Marianna; Witkowski Adam; Zmudka Krzysztof

来源：Arteriosclerosis, Thrombosis, and Vascular Biology, 2010, 30(2): 276-U287.

DOI：10.1161/ATVBAHA.109.194936

• angioplasty
• fibrin
• fibrinolysis
• stents
• thrombosis

Objectives-We sought to investigate whether patients with in-stent thrombosis (IST) display altered plasma fibrin clot properties.
Methods and Results-We studied 47 definite IST patients, including 15 with acute, 26 subacute and 6 late IST, and 48 controls matched for demographics, cardiovascular risk factors, concomitant treatment and angiographic/stent parameters. Plasma clot permeability (K(s)), which indicates a pore size, turbidity (lag phase, indicating the rate of fibrin clot formation, Delta Abs(max), maximum absorbance of a fibrin gel, reflecting the fiber thickness), lysis time (t(50%)) and maximum rate of D-dimer release from clots (D-D(rate)) were determined 2 to 73 (median 14.7) months after IST. Patients with IST had 21% lower K(s), 14% higher Delta Abs(max), 11% lower D-Drate, 30% longer t(50%) (all P<0.0001) and 5% shorter lag phase compared to controls (P=0.042). There were no correlations between clot variables and the time of IST or that from IST to blood sampling. Multiple regression analysis showed that K(s) (odds ratio=0.36 per 0.1 mu m(2), P<0.001), D-Drate (odds ratio= 0.16 per 0.01mg/L/min, P<0.001) and stent length (odds ratio=1.1 per 1 mm, P=0.043) were independent predictors of IST (R(2)=0.58, P<0.001).
Conclusions-IST patients tend to form dense fibrin clots resistant to lysis, and altered plasma fibrin clot features might contribute to the occurrence of IST. (Arterioscler Thromb Vasc Biol. 2010; 30:276-282.)

• 出版日期2010-2