Thrombin-activatable fibrinolysis inhibitor (TAFI): a novel predictor of angiographic coronary restenosis

Herbert K. Lau; Amit Segev; Robert A. Hegele; John D. Sparkes; Jerome M.Teitel; Robert J. Chisholm; Bradley H. Strauss

doi:10.1160/TH03-05-0308

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2003; 90(06): 1187-1191
DOI: 10.1160/TH03-05-0308

Vascular Development and Vessel Remodelling

Schattauer GmbH

Thrombin-activatable fibrinolysis inhibitor (TAFI): a novel predictor of angiographic coronary restenosis

Authors

Herbert K. Lau^*

²The Division of Hematology and Oncology, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
Amit Segev^*

¹The Roy and Ann Foss Cardiovascular Research Program, Terrence Donnelly Heart Center, Toronto, Ontario, Canada
Robert A. Hegele

³The John P. Robarts Research Institute, London, Ontario, Canada
John D. Sparkes

¹The Roy and Ann Foss Cardiovascular Research Program, Terrence Donnelly Heart Center, Toronto, Ontario, Canada
Jerome M.Teitel

²The Division of Hematology and Oncology, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
Robert J. Chisholm

¹The Roy and Ann Foss Cardiovascular Research Program, Terrence Donnelly Heart Center, Toronto, Ontario, Canada
Bradley H. Strauss

¹The Roy and Ann Foss Cardiovascular Research Program, Terrence Donnelly Heart Center, Toronto, Ontario, Canada

Abstract

Summary

The fibrinolytic system is closely related to several processes that are involved in restenosis. We previously showed that low PAI-1 plasma levels predicted restenosis. Recently, a different fibrinolytic inhibitor, TAFI, has been described. The aims of this study were to evaluate the relationship between pre-procedural plasma levels of TAFI and late angiographic restenosis and the interaction between TAFI and PAI-1. We prospectively studied 159 patients with stable angina who underwent successful elective angioplasty or stenting of de novo native coronary artery lesions. TAFI and PAI-1 antigen levels were measured in plasma samples drawn before the procedure. Follow-up coronary angiography was performed in 92% of patients. There was a significant correlation between pre-procedural TAFI levels and 6-month % diameter stenosis (DS) (r = 0.21; p = 0.013). The overall angiographic restenosis rate (DS>50%) was 31%. Pre-procedural TAFI levels were significantly higher in patients with restenosis (108 ± 33% versus 94±30%, p = 0.011). Restenosis rates for patients in the upper tertile of TAFI levels were 2-fold higher than for those in the lowest tertile (45% versus 22%; p = 0.016). A combination of high TAFI and low PAI-1 levels identified patients at the highest risk of restenosis (53%) compared to 14% in patients with low TAFI and high PAI-1 levels; p = 0.027. In conclusion, pre-procedural plasma TAFI antigen levels identify patients at increased risk for restenosis after PCI.

Keywords

TAFI - PAI-1 - restenosis - fibrinolysis

Full Text

References

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