thromboplastin and Coronary-Occlusion

In the presence of a chronically occluded coronary artery, the collateral circulation matures by a process of arteriogenesis; however, there is considerable variation between individuals in the functional capacity of that collateral network. This could be explained by differences in endothelial health and function. We aimed to examine the relationship between the functional extent of collateralization and levels of biomarkers that have been shown to relate to endothelial health.. We measured four potential biomarkers of endothelial health in 34 patients with mature collateral networks who underwent a successful percutaneous coronary intervention (PCI) for a chronic total coronary occlusion (CTO) before PCI and 6-8 weeks after PCI, and examined the relationship of biomarker levels with physiological measures of collateralization.. We did not find a significant change in the systemic levels of sICAM-1, sE-selectin, microparticles or tissue factor 6-8 weeks after PCI. We did find an association between estimated retrograde collateral flow before CTO recanalization and lower levels of sICAM-1 (r=0.39, P=0.026), sE-selectin (r=0.48, P=0.005) and microparticles (r=0.38, P=0.03).. Recanalization of a CTO and resultant regression of a mature collateral circulation do not alter systemic levels of sICAM-1, sE-selectin, microparticles or tissue factor. The identified relationship of retrograde collateral flow with sICAM-1, sE-selectin and microparticles is likely to represent an association with an ability to develop collaterals rather than their presence and extent.

Topics: Aged; Biomarkers; Cardiac Catheterization; Cell-Derived Microparticles; Chronic Disease; Collateral Circulation; Coronary Angiography; Coronary Circulation; Coronary Occlusion; Coronary Vessels; England; Female; Humans; Intercellular Adhesion Molecule-1; Male; Middle Aged; P-Selectin; Percutaneous Coronary Intervention; Predictive Value of Tests; Thromboplastin; Time Factors; Treatment Outcome; Vascular Resistance

During myocardial infarction, platelet activation and endothelial apoptosis are responsible for the release of procoagulant membrane-derived microparticles (MPs) in the bloodstream. Few data are available on the potential role played by MPs in coronary atherothrombosis. In the present study, we investigated the levels and cellular origins of MPs within the occluded coronary artery of patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty (PCI).. A total of 12 patients with STEMI treated by primary PCI within 24h of symptom onset were included in this study. MPs procoagulant activity and cellular origin were characterized within the occluded coronary artery before PCI (C(0)), after restoration of the epicardial blood flow (C(1)), and in blood collected from the femoral artery (F).. Levels of leukocyte-derived CD11a(+) MPs, endothelial-derived CD105(+) MPs, and tissue factor (TF)-bearing MPs were significantly higher within the occluded coronary artery than in peripheral blood samples. Restoration of the epicardial blood flow led to a significant reduction of procoagulant CD11a(+) and CD105(+) MPs by 30% and 42%, respectively (p<0.05).. Elevation of procoagulant MPs within the occluded coronary artery of patients with STEMI suggests their pathophysiological role in coronary atherothrombosis.

Topics: Adult; Angioplasty, Balloon, Coronary; Antigens, CD; Apoptosis; CD11a Antigen; Cell-Derived Microparticles; Coronary Circulation; Coronary Occlusion; Coronary Thrombosis; Endoglin; Endothelium, Vascular; Female; Humans; Leukocytes; Male; Middle Aged; Myocardial Infarction; Receptors, Cell Surface; Thromboplastin; Treatment Outcome; Up-Regulation

Topics: Angioplasty, Balloon, Coronary; Biopsy; Blood Cell Count; Bone Marrow; Coronary Occlusion; Coronary Thrombosis; Humans; Incidental Findings; Leukemia, Promyelocytic, Acute; Male; Middle Aged; Myocardial Infarction; Pancytopenia; Radiography; Thromboplastin

Topics: Coronary Occlusion; Dicumarol; Heart; Humans; Thromboplastin

Topics: Coronary Occlusion; Heart; Humans; Thromboplastin