Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.727
Index Copernicus  – 166.39
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 1, January-February, p. 93–98

doi: 10.17219/acem/38160

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Tissue Factor and Other Hemostatic Parameters in Patients with Advanced Peripheral Artery Disease After Endovascular Revascularization – Search for Hemostatic Factors which Indicate Restenosis

Daniel Kotschy1,A,B,C,E, Maria Kotschy1,C,D, Paweł Socha1,G, Leszek Masłowski1,G, Justyna Kwapisz1,B, Natalia Żuk1,G, Joanna Dubis1,G, Maciej Karczewski1,G, Wojciech Witkiewicz1,F

1 WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland

Abstract

Background. In patients with peripheral artery disease (PAD) a hypercoagulable state and thromboembolic complications occur. Revascularization procedures increase this state, sometimes leading to restenosis. Restenosis following balloon angioplasty (PTA)and stent implantation is ≥ 50% of artery stenosis.
Objectives. To determine the concentration of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin–antithrombin (TAT) complexes, fibrinogen and D-dimers in the blood of patients with PAD after peripheral endovascular revascularization of the lower legs and in PAD patients with restenosis.
Material and Methods. The study included 150 patients with PAD, 90 men and 60 women, aged 44–88 (mean 65.5) years, after successful peripheral angioplasty (PTA) and/or with stenting. During the 6 months after the revascularization procedures, restenosis occurred in 27 patients. The reference group consisted of 53 healthy persons (44 men and 9 women, aged 20–56 years). Blood was drawn in the morning into 3.2% natrium citrate at a ratio of 9 : 1. The concentration of TF, TFPI, TAT complexes and D-dimers were measured in plasma with commercial tests using an enzyme immunoassay. Fibrinogen was determined with coagulometer.
Results. In the plasma of patients with PAD after endovascular revascularization, the concentrations of TF, TAT complexes, fibrinogen and D-dimers were significantly higher compared to the reference group. During the six months of observation, 27 patients developed restenosis. The results of hemostatic factors in patients with restenosis were compared with the same patients before restenosis and the group of 123 PAD patients after endovascular revascularization. TF and fibrinogen levels in the 27 patients with restenosis were significantly higher than in the group of PAD patients before restenosis.
Conclusion. Statistically significantly higher levels of tissue factor (TF) and fibrinogen in PAD patients with new restenosis, compared to those without restenosis after endovascular revascularization, indicate they can participate in the formation of restenosis.

Key words

PAD, endovascular revascularization, restenosis, hemostasis.

References (23)

  1. Strano A, Hoppensteadt D, Walenga JM, Fareed J, Saba C, Berard E: Plasma levels of the molecular markers of coagulation and fibrinolysis in patients with peripheral arterial disease. Semin Thromb Hemost 1996, 22 Suppl 1, 35–40.
  2. Makin A, Silverman SH, Lip GY: Peripheral vascular disease and Virchow’s triad for thrombogenesis. QJM 2002, 95, 199–210.
  3. Cassar K, Bachoo P, Ford I, Greaves M, Brittenden J: Markers of coagulation activation endothelial stimulation and inflammation in patients with peripheral arterial disease. Eur J Vasc Endovasc Surg 2005, 29, 171–176.
  4. Migdalski A, Jawień A, Kotschy M, Knapik-Bieniek A: Selected haemostatic factors in carotid bifurcation plaques of patients undergoing carotid endarterectomy. Eur J Vasc Endovasc Surg 2004, 27, 172–179.
  5. Migdalski A, Kotschy M, Jawień A: Tissue factor, tissue factor pathway inhibitor and vascular endothelial growth factor-A in carotid atherosclerotic plaques. Eur J Vasc Endovasc Surg 2005, 30, 41–47.
  6. Lwaleed BA, Bass PS: Tissue factor pathway inhibitor: structure, biology and involvement in disease. J Pathol 2006, 208, 327–339.
  7. Kotschy M, Kotschy D, Witkiewicz W: Rola czynnika tkankowego i jego inhibitora w procesie krzepnięcia krwi oraz w powikłaniach zakrzepowych. Kardiol Pol 2010, 10, 1158–1162.
  8. Ross R: The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993, 362, 801–809.
  9. Rowe VL, Lee W, Weaver FA, Etzioni D: Patterns of treatment for peripheral arterial disease in the United States: 1996–2005. J Vasc Surg 2009, 49, 910–917.
  10. Gabrusiewicz A, Słowiński P, Krosny T, Staszkiewicz W: The present state of the art of the pathophysiology, diagnosis and treatment of the superficial femoral artery occlusion based on own results. Post N Med 2012, 25, 612–616.
  11. Bennett MR: In-stent stenosis: pathology and implications for the development of drug eluting stents. Heart 2003, 89, 218–224.
  12. Goodney PP, Beck AW, Nagle J: National trends in lower extremity bypass surgery, endovascular interventions, and major amputations. J Vasc Surg 2009, 50, 54–60.
  13. Brevetti G, Schiano V, Chiariello M: Endothelial dysfunction: a key to the pathophysiology and natural history of peripheral arterial disease. Atherosclerosis 2008, 197, 1–11.
  14. Kotschy D, Kotschy M, Masłowski L, Socha P, Kwapisz J, Czyżewska-Buczyńska A, Karczewski M, Witkiewicz W: Inflammatory markers in peripheral arterial diseases patients after endovascular revascularization with new restenosis. Acta Angiol 2014, 20, 47–59.
  15. Radziwon P, Bielawiec M, Kłoczko J, Giedrojć J, Mazgajska K, Galar M: Tissue factor pathway inhibitor (TFPI) in patients with occlusive arterial diseases in consideration with risk factors and conservative treatment of the disease. Acta Angiol 2001, 7, 43–54.
  16. Pärsson H, Holmberg A, Siegbahn A, Bergqvist D: Activation of coagulation and fibrinolytic systems in patients with CLI is not normalized after surgical revascularisation. Eur J Vasc Endovasc Surg 2004, 27, 186–192.
  17. Tschöpl M, Tsakiris DA, Marbet GA, Labs KW, Jäger K: Role of hemostatic risk factors for restenosis in peripheral arterial occlusive disease after transluminal angioplasty. Arterioscler Thromb Vasc Biol 1997, 17, 3208–3214.
  18. Schillinger M, Exner M, Mlekusch W, Rumpold H, Ahmadi R, Sabeti S: Vascular inflammation and percutaneous transluminal angioplasty of the femoropopliteal artery: association with restenosis. Radiology 2002, 225, 21–26.
  19. Steffel J, Lüscher TF, Tanner FC: Tissue Factor in Cardiovascular Diseases. Circulation 2006, 113, 722–731.
  20. Joseph L, Fink LM, Hauer-Jensen M: Cytokines in coagulation and thrombosis: a preclinical and clinical review. Blood Coagul Fibrinolysis 2002, 13, 105–116.
  21. Nijm J, Wikby A, Tompa A: Circulating levels of proinflammatory cytokines and neutrophil-platelet aggregates in patients with coronary artery disease. Am J Cardiol 2005, 95, 452–456.
  22. Schillinger M, Exner M, Mlekusch W: Endovascular revascularization below the knee: 6-month results and predictive value of C-reactive protein level. Radiology 2003, 227, 419–425.
  23. Mizuno O, Ikeda U, Hojo Y: Tissue factor expression in coronary circulation as a prognostic factor for late restenosis after coronary angioplasty. Cardiology 2001, 95, 84–89.