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AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ

Year 2020, Volume: 22 Issue: 1, 71 - 78, 30.04.2020
https://doi.org/10.24938/kutfd.659050

Abstract

Amaç: İn-stent restenoz, koroner arterlere stent implantasyonu sonrası stentli bölgenin aşamalı olarak yeniden daralmasıdır. İlaç salınımlı stentlerin kullanılmaya başlanmasıyla restenoz oranları azalmış olsa da hala majör problem olmaya devam etmektedir. Bu çalışmada akut koroner sendrom nedeniyle koroner anjiyografi yapılan hastalarda in-stent restenozu ile fibrinojen düzeyi arasındaki ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntemler: İki grup arasında yaş, hipertansiyon, diyabetes mellitus, sigara içimi ve sol ventrikül ejeksiyon fraksiyonu açısından fark yoktu (p>0.005, hepsi için). İSR grubunda erkek cinsiyet ve hiperlipidemi oranı İSR olmayan gruba göre daha yüksekti (sırasıyla, p=0.04; 0.007). Biyokimyasal parametrelerden homosistein ve fibrinojen dışında iki grup arasında fark izlenmedi. Serum homosistein ve fibrinojen seviyesi İSR olan grupta İSR olmayan gruba göre istatistiksel olarak anlamlı derecede yüksek saptandı (sırasıyla, p=0.009; 0.032). Dislipidemi, homosistein ve fibrinojen İSR'nin bağımsız prediktörleri olarak saptandı.
Bulgular: Tedavi sonrası WOMAC ağrı, WOMAC tutukluk, WOMAC fonksiyonel durum ve WOMAC toplam skorlarında tedavi öncesi değerlere göre her iki grupta da istatistiksel olarak anlamlı gelişme saptandı (p<0.001). Ancak tedavi sonuçları arasında gruplar arası istatistiki olarak anlamlı fark saptanmadı.
Sonuç: Koroner arter hastalığı nedeniyle çıplak metal stent implante edilmiş hastalarda plazma fibrinojen düzeyi İSR riskini öngörmede yardımcı olabilecek önemli bir biyokimyasal parametre olabilir.

References

  • 1. Mann DL, Zipes DP, Libby P, Braunwald E, Bonow RO. Braunwald's heart disease: a textbook of cardiovascular medicine. 10th ed. Philadelphia. Elsevier, Saunders, 2015.
  • 2. Rajagopal V, Rockson SG. Coronary restenosis: a review of mechanisms and management. Am J Med. 2003;115(7):547-53.
  • 3. Lowe HC, Oesterle SN, Khachigian LM. Coronary instent restenosis: current status and future strategies. J Am Coll Cardiol. 2002;39(2):183-93.
  • 4. Farb A, Sangiorgi G, Carter AJ, Walley VM, Edwards WD, Schwartz RS et al. Pathology of acute and chronic coronary stenting in humans. Circulation. 1999;99(1):44-52.
  • 5. Smith EB, Thompson WD, Crosbie L, Stirk CM. Fibrinogen/fibrin in atherogenesis. Eur J Epidemiol. 1992;8(Suppl 1):83-7.
  • 6. Ang L, Behnamfar O, Palakodeti S, Lin F, Pourdjabbar A, Patel MP et al. Elevated baseline serum fibrinogen: effect on 2-year major adverse cardiovascular events following percutaneous coronary intervention. J Am Heart Assoc. 2017;6(11):e006580.
  • 7. Mahmud E, Ramsis M, Behnamfar O, Enright K, Huynh A, Kaushal K et al. Effect of serum fibrinogen, total stent length, and type of acute coronary syndrome on 6-month major adverse cardiovascular events and bleeding after percutaneous coronary intervention. Am J Cardiol. 2016;117(10):1575-81.
  • 8. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as risk factor for stroke and myocardial infarction. N Engl J Med. 1984;311(8):501-5.
  • 9. Toss H, Lindahl B, Siegbahn A, Wallentin L. Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease. Circulation. 1997;96(12):4204-10.
  • 10. Folsom AR, Wu KK, Rosamond WD, Sharrett AR, Chambless LE. Prospective study of hemostatic factors and incidence of coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 1997;96(4):1102-8.
  • 11. Otsuka M, Hayashi Y, Ueda H, Imazu M, Kohno N. Predictive value of preprocedural fibrinogen concerning coronary stenting. Atherosclerosis. 2002;164(2):371-8.
  • 12. Lupi A, Secco GG, Rognoni A, Rossi L, Lazzero M, Nardi F. Plasma fibrinogen levels and restenosis after primary percutaneous coronary intervention. J Thromb Thrombolysis. 2012;33(4):308-17.
  • 13. Jukema JW, Verschuren JJ, Ahmed TA, Quax PH. Restenosis after PCI. Part 1: pathophysiology and risk factors. Nat Rev Cardiol. 2011;9(1):53-62.
  • 14. Naito M, Stirk C, Smith E, Thompson W. Smooth muscle cell outgrowth stimulated by fibrin degradation products. The potential role of fibrin E in restenosis and atherogenesis. Thromb Res. 2000;98(2):165-74.
  • 15. Yarnell JWG, Baker IA, Sweetnam PM, Bainton D, O’Brien JR, Whitehead PJ et al. Fibrinogen, viscosity and White blood cell count are major risk factors for ischemic heart disease: the Caerphilly and Speedwell collaborative heart disease studies. Circulation. 1991;83(3):836-44.
  • 16. Collaborative metaanalysis of prospective studies of plasma fibrinogen and cardiovascular disease. Eur J Cardiovasc Prev Rehabil. 2004;11(1):9-17.
  • 17. Handa K, Kono S, Saku K, Sasaki J, Kawano T, Sasaki Y et al. Plasma fibrinogen levels as an independent indicator of severity of coronary atherosclerosis. Atherosclerosis. 1989;77(2-3):209-13.
  • 18. Broadhurst P, Kelleher C, Hughes L, Imeson JD, Raftery EB. Fibrinogen, factor VII clotting activity and coronary artery disease severity. Atherosclerosis.1990;85(2-3):169-73.
  • 19. Schumacher M, Eber B, Tiran A, Toplak H, Luha O, Gasser R et al. Fibrinogen values in patients with and without restenosis following percutaneous transluminal coronary angioplasty. Cardiology. 1992;80(5-6):345-8.
  • 20. Rahel M, Visseren FLJ, Suttorp MJ, Plokker THW, Kelder JC, de Jongh BM et al. Preprocedural serum levels of acute-phase reactants and prognosis after percutaneous coronary intervention. Cardiovasc Res. 2003;60(1):136-40.
  • 21. Assadpour Piranfar M. The Correlation between high-sensitivity c-reactive protein (HSCRP) serum levels and severity of coronary atherosclerosis. Int Cardiovasc Res J. 2014;8(1):6-8.
  • 22. Koenig W. High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy. Int J Cardiol. 2013;168(6):5126-34.
  • 23. Baktashian M, Saffar Soflaei S, Kosari N, Salehi M, Khosravi A, Ahmadinejad M et al. Association of high level of hs-CRP with in-stent restenosis: A case-control study. Cardiovasc Revasc Med. 2019;20(7):583-7.
  • 24. Yeter E, Aygül N, Kayrak M, Tokaç M, Gök H. Revaskülarizasyon sonrası restenozun efor testi ile değerlendirilmesi ve restenoz için bir risk olarak fibrinojen ve C-reaktif proteinin değeri. Genel Tıp Derg. 2005;15(3):111-5.
  • 25. Hong SJ, Kim MH, Ahn TH, Ahn YK, Bae JH, Shim WJ et al. Multiple predictors of coronary restenosis after drug-eluting stent implantation in patients with diabetes. Heart. 2006;92(8):1119- 24.
  • 26. Hu RT, Liu J, Zhou Y, Hu BL. Association of smoking with restenosis and major adverse cardiac events after coronary stenting: A meta-analysis. Pak J Med Sci. 2015;31(4):1002-8.
  • 27. Tocci G, Barbato E, Coluccia R, Modestino A, Pagliaro B, Mastromarino V et al. Blood pressure levels at the time of percutaneous coronary revascularization and risk of coronary ın-stent restenosis. Am J Hypertens. 2016;29(4):509-18.
  • 28. Veinot JP, Edwards WD, Camrud AR, Jorgenson MA, Holmes DR Jr, Schwartz RS. The effects of lovastatin on neointimal hyperplasia following injury in a porcine coronary artery model. Can J Cardiol. 1996;12(1):65-70.
  • 29. Bertrand ME, McFadden EP, Fruchart JC, Van Belle E, Commeau P, Grollier G et al. Effect of pravastatin on angiographic restenosis after coronary balloon angioplasty. The PREDICT Trial Investigators. Prevention of restenosis by elisor after transluminal coronary angioplasty. J Am Coll Cardiol. 1997;30(4):863-9.
  • 30. Weintraub WS, Boccuzzi SJ, Klein JL, Kosinski AS, King SB 3rd, Ivanhoe R et al. Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group. N Engl J Med. 1994;331(20):1331-7.
  • 31. Violaris AG, Melkert R, Serruys PW. Influence of serum cholesterol and cholesterol subfractions on restenosis after successful coronary angioplasty. A quantitative angiographic analysis of 3336 lesions. Circulation. 1994;90(5):2267-79.
  • 32. Luca GD, Suryapranata H, Gregorio G, Lange H, Chiariello M. Homocysteine and its effects on in-stent restenosis. Circulation. 2005;112(19):307-11.

The Relationship Between Serum Fibrinogen Level and Stent Restenosis in Patients with Acute Coronary Syndrome

Year 2020, Volume: 22 Issue: 1, 71 - 78, 30.04.2020
https://doi.org/10.24938/kutfd.659050

Abstract

Objective: In-stent restenosis (ISR) is a gradual re-constriction of the stented area after stent implantation in the coronary arteries. Although the rate of re-stenosis was decreased after using drug-induced stents, it still remains as a major problem. In this study, we aimed to investigate the relationship between ISR and fibrinogen levels in patients undergoing coronary angiography for acute coronary syndrome.
Material and Methods: We enrolled 321 patients with a history of coronary angioplasty who underwent coronary angiography between December 2014 and June 2019. The patients were grouped in two as patients with and without stent restenosis and their biochemical data were analyzed.
Results: There was no difference between the groups in terms of age, hypertension, diabetes mellitus, smoking and left ventricular ejection fraction (p>0.005, for all). Male gender and hyperlipidemia rate were higher in ISR group than non-ISR group (p=0.04; 0.007 respectively). Biochemical parameters were not different between the groups except for homocysteine and fibrinogen. Serum homocysteine and fibrinogen levels were significantly higher in the ISR group than in the non-ISR group (p=0.009; 0.032 respectively). Dyslipidemia, homocysteine and fibrinogen were identified as independent predictors of ISR.
Conclusion: Plasma fibrinogen levels may be an important biochemical parameter in predicting the risk of restenosis in patients with bare metal stents implanted for coronary artery disease.

References

  • 1. Mann DL, Zipes DP, Libby P, Braunwald E, Bonow RO. Braunwald's heart disease: a textbook of cardiovascular medicine. 10th ed. Philadelphia. Elsevier, Saunders, 2015.
  • 2. Rajagopal V, Rockson SG. Coronary restenosis: a review of mechanisms and management. Am J Med. 2003;115(7):547-53.
  • 3. Lowe HC, Oesterle SN, Khachigian LM. Coronary instent restenosis: current status and future strategies. J Am Coll Cardiol. 2002;39(2):183-93.
  • 4. Farb A, Sangiorgi G, Carter AJ, Walley VM, Edwards WD, Schwartz RS et al. Pathology of acute and chronic coronary stenting in humans. Circulation. 1999;99(1):44-52.
  • 5. Smith EB, Thompson WD, Crosbie L, Stirk CM. Fibrinogen/fibrin in atherogenesis. Eur J Epidemiol. 1992;8(Suppl 1):83-7.
  • 6. Ang L, Behnamfar O, Palakodeti S, Lin F, Pourdjabbar A, Patel MP et al. Elevated baseline serum fibrinogen: effect on 2-year major adverse cardiovascular events following percutaneous coronary intervention. J Am Heart Assoc. 2017;6(11):e006580.
  • 7. Mahmud E, Ramsis M, Behnamfar O, Enright K, Huynh A, Kaushal K et al. Effect of serum fibrinogen, total stent length, and type of acute coronary syndrome on 6-month major adverse cardiovascular events and bleeding after percutaneous coronary intervention. Am J Cardiol. 2016;117(10):1575-81.
  • 8. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as risk factor for stroke and myocardial infarction. N Engl J Med. 1984;311(8):501-5.
  • 9. Toss H, Lindahl B, Siegbahn A, Wallentin L. Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease. Circulation. 1997;96(12):4204-10.
  • 10. Folsom AR, Wu KK, Rosamond WD, Sharrett AR, Chambless LE. Prospective study of hemostatic factors and incidence of coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 1997;96(4):1102-8.
  • 11. Otsuka M, Hayashi Y, Ueda H, Imazu M, Kohno N. Predictive value of preprocedural fibrinogen concerning coronary stenting. Atherosclerosis. 2002;164(2):371-8.
  • 12. Lupi A, Secco GG, Rognoni A, Rossi L, Lazzero M, Nardi F. Plasma fibrinogen levels and restenosis after primary percutaneous coronary intervention. J Thromb Thrombolysis. 2012;33(4):308-17.
  • 13. Jukema JW, Verschuren JJ, Ahmed TA, Quax PH. Restenosis after PCI. Part 1: pathophysiology and risk factors. Nat Rev Cardiol. 2011;9(1):53-62.
  • 14. Naito M, Stirk C, Smith E, Thompson W. Smooth muscle cell outgrowth stimulated by fibrin degradation products. The potential role of fibrin E in restenosis and atherogenesis. Thromb Res. 2000;98(2):165-74.
  • 15. Yarnell JWG, Baker IA, Sweetnam PM, Bainton D, O’Brien JR, Whitehead PJ et al. Fibrinogen, viscosity and White blood cell count are major risk factors for ischemic heart disease: the Caerphilly and Speedwell collaborative heart disease studies. Circulation. 1991;83(3):836-44.
  • 16. Collaborative metaanalysis of prospective studies of plasma fibrinogen and cardiovascular disease. Eur J Cardiovasc Prev Rehabil. 2004;11(1):9-17.
  • 17. Handa K, Kono S, Saku K, Sasaki J, Kawano T, Sasaki Y et al. Plasma fibrinogen levels as an independent indicator of severity of coronary atherosclerosis. Atherosclerosis. 1989;77(2-3):209-13.
  • 18. Broadhurst P, Kelleher C, Hughes L, Imeson JD, Raftery EB. Fibrinogen, factor VII clotting activity and coronary artery disease severity. Atherosclerosis.1990;85(2-3):169-73.
  • 19. Schumacher M, Eber B, Tiran A, Toplak H, Luha O, Gasser R et al. Fibrinogen values in patients with and without restenosis following percutaneous transluminal coronary angioplasty. Cardiology. 1992;80(5-6):345-8.
  • 20. Rahel M, Visseren FLJ, Suttorp MJ, Plokker THW, Kelder JC, de Jongh BM et al. Preprocedural serum levels of acute-phase reactants and prognosis after percutaneous coronary intervention. Cardiovasc Res. 2003;60(1):136-40.
  • 21. Assadpour Piranfar M. The Correlation between high-sensitivity c-reactive protein (HSCRP) serum levels and severity of coronary atherosclerosis. Int Cardiovasc Res J. 2014;8(1):6-8.
  • 22. Koenig W. High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy. Int J Cardiol. 2013;168(6):5126-34.
  • 23. Baktashian M, Saffar Soflaei S, Kosari N, Salehi M, Khosravi A, Ahmadinejad M et al. Association of high level of hs-CRP with in-stent restenosis: A case-control study. Cardiovasc Revasc Med. 2019;20(7):583-7.
  • 24. Yeter E, Aygül N, Kayrak M, Tokaç M, Gök H. Revaskülarizasyon sonrası restenozun efor testi ile değerlendirilmesi ve restenoz için bir risk olarak fibrinojen ve C-reaktif proteinin değeri. Genel Tıp Derg. 2005;15(3):111-5.
  • 25. Hong SJ, Kim MH, Ahn TH, Ahn YK, Bae JH, Shim WJ et al. Multiple predictors of coronary restenosis after drug-eluting stent implantation in patients with diabetes. Heart. 2006;92(8):1119- 24.
  • 26. Hu RT, Liu J, Zhou Y, Hu BL. Association of smoking with restenosis and major adverse cardiac events after coronary stenting: A meta-analysis. Pak J Med Sci. 2015;31(4):1002-8.
  • 27. Tocci G, Barbato E, Coluccia R, Modestino A, Pagliaro B, Mastromarino V et al. Blood pressure levels at the time of percutaneous coronary revascularization and risk of coronary ın-stent restenosis. Am J Hypertens. 2016;29(4):509-18.
  • 28. Veinot JP, Edwards WD, Camrud AR, Jorgenson MA, Holmes DR Jr, Schwartz RS. The effects of lovastatin on neointimal hyperplasia following injury in a porcine coronary artery model. Can J Cardiol. 1996;12(1):65-70.
  • 29. Bertrand ME, McFadden EP, Fruchart JC, Van Belle E, Commeau P, Grollier G et al. Effect of pravastatin on angiographic restenosis after coronary balloon angioplasty. The PREDICT Trial Investigators. Prevention of restenosis by elisor after transluminal coronary angioplasty. J Am Coll Cardiol. 1997;30(4):863-9.
  • 30. Weintraub WS, Boccuzzi SJ, Klein JL, Kosinski AS, King SB 3rd, Ivanhoe R et al. Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group. N Engl J Med. 1994;331(20):1331-7.
  • 31. Violaris AG, Melkert R, Serruys PW. Influence of serum cholesterol and cholesterol subfractions on restenosis after successful coronary angioplasty. A quantitative angiographic analysis of 3336 lesions. Circulation. 1994;90(5):2267-79.
  • 32. Luca GD, Suryapranata H, Gregorio G, Lange H, Chiariello M. Homocysteine and its effects on in-stent restenosis. Circulation. 2005;112(19):307-11.
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Muhammed Karadeniz 0000-0003-2432-0378

Taner Sarak 0000-0002-5538-502X

Publication Date April 30, 2020
Submission Date December 13, 2019
Published in Issue Year 2020 Volume: 22 Issue: 1

Cite

APA Karadeniz, M., & Sarak, T. (2020). AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 22(1), 71-78. https://doi.org/10.24938/kutfd.659050
AMA Karadeniz M, Sarak T. AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ. Kırıkkale Uni Med J. April 2020;22(1):71-78. doi:10.24938/kutfd.659050
Chicago Karadeniz, Muhammed, and Taner Sarak. “AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22, no. 1 (April 2020): 71-78. https://doi.org/10.24938/kutfd.659050.
EndNote Karadeniz M, Sarak T (April 1, 2020) AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 1 71–78.
IEEE M. Karadeniz and T. Sarak, “AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ”, Kırıkkale Uni Med J, vol. 22, no. 1, pp. 71–78, 2020, doi: 10.24938/kutfd.659050.
ISNAD Karadeniz, Muhammed - Sarak, Taner. “AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22/1 (April 2020), 71-78. https://doi.org/10.24938/kutfd.659050.
JAMA Karadeniz M, Sarak T. AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ. Kırıkkale Uni Med J. 2020;22:71–78.
MLA Karadeniz, Muhammed and Taner Sarak. “AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol. 22, no. 1, 2020, pp. 71-78, doi:10.24938/kutfd.659050.
Vancouver Karadeniz M, Sarak T. AKUT KORONER SENDROMDA SERUM FİBRİNOJEN DÜZEYİ İLE STENT RESTENOZU ARASINDAKİ İLİŞKİ. Kırıkkale Uni Med J. 2020;22(1):71-8.

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