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Plasma fibrinogen levels and restenosis after primary percutaneous coronary intervention

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Abstract

Plasma fibrinogen levels influence restenosis following elective percutaneous coronary intervention (PCI) for stable angina. It is unknown whether the same is true in the setting of primary PCI. The aim of the study was therefore to assess whether fibrinogen levels were associated to 6-month in-stent restenosis (ISR) in STEMI patients undergoing successful primary PCI. From January 2003 to October 2004, 267 patients were admitted to our Institution for STEMI and treated by primary PCI. Of these, 171 patients met the inclusion criteria and were enrolled in our study. Fibrinogen levels were assessed at admission, 12 h, 24 h, 48 h, 72 h following PCI and at discharge. Six-month angiographic follow-up was 100% complete. Subjects with 6-month ISR showed higher fibrinogen levels than patients without ISR. Patients in the upper fibrinogen tertile showed a higher 6-month incidence of symptoms and/or inducible myocardial ischemia (27.1% vs. 7.1%, P = 0.006) and a larger late lumen loss (1.3 ± 0.8 vs. 1.0 ± 0.9 mm, P = 0.049). Logistic regression analysis demonstrated a significant and independent association between fibrinogen levels and ISR. Our study suggests that increased plasma fibrinogen levels are related to ISR in STEMI patients undergoing primary PCI. Larger studies are warranted to assess the prognostic value of fibrinogen over harder end-points.

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Abbreviations

PCI:

Percutaneous coronary intervention

STEMI:

ST-elevation acute myocardial infarction

ISR:

In-stent restenosis

IRA:

Infarct-related artery

TLR:

Target lesion revascularization

MLD:

Minimal lumen diameter

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Authors and Affiliations

  1. Cardiologia Ospedaliera, Ospedale Maggiore della Carità, Cso Mazzini 18, 28100, Novara, Italy

    Alessandro Lupi, Andrea Rognoni, Lidia Rossi, Maurizio Lazzero & Angelo Sante Bongo

  2. Division of Cardiology, University of Eastern Piedmont, “Maggiore della Carità” Hospital, Novara, Italy

    Gioel Gabrio Secco

  3. Division of Cardiology, Ospedale Castelli, Verbania, Italy

    Federico Nardi

  4. Clinical Chemistry, “Maggiore della Carità” Hospital, Novara, Italy

    Roberta Rolla & Giorgio Bellomo

  5. Department of Cardiology, Royal Brompton Hospital, London, UK

    Carlo Di Mario

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  1. Alessandro Lupi
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  2. Gioel Gabrio Secco
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Correspondence to Alessandro Lupi.

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Lupi, A., Secco, G.G., Rognoni, A. et al. Plasma fibrinogen levels and restenosis after primary percutaneous coronary intervention. J Thromb Thrombolysis 33, 308–317 (2012). https://doi.org/10.1007/s11239-011-0628-z

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  • DOI: https://doi.org/10.1007/s11239-011-0628-z

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