THROMBIN GENERATION IN HUMAN CORONARY-ARTERIES AFTER PERCUTANEOUS TRANSLUMINAL BALLOON ANGIOPLASTY

Objectives. The aim of this study was to investigate the relation between coronary atherosclerotic plague injury and activation of the Coagulation cascade. Background. Thrombus formation after atherosclerotic plaque disruption has been implicated in the pathogenesis of atherosclerosis, unstable angina and myocardial infarction. Methods. Biochemical markers of thrombin generation (prothrombin fragment F-1+2) and thrombin activity (fibrinopeptide A) were measured in coronary blood before, during and immediately after percutaneous transluminal coronary angioplasty. After demonstrating that blood withdrawal through an angioplasty catheter does not artifactually elevate the plasma levels of these markers in patients after heparinization, coronary artery samples were collected proximal and distal to the lesion before and distal to the lesion after balloon inflation in 26 patients. Results. Plasma levels of F-1+2 measured proximal to the lesion before angioplasty (median 0.47 nmol/liter, 95% confidence interval [CI] 0.40 to 0.50) were significantly elevated after angioplasty (median 0.55 nmol/liter, 95% CI 0.46 to 0.72, p = 0.001). In