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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation
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Protein C and/or protein S deficiency and occurrence of stent thrombosis: a hitherto unrecognized association

Pravin K Goel1, Aditya Batra

  • 1Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. golf_pgi@yahoo.co.in

Journal of Interventional Cardiology
|September 10, 2010
PubMed

Insights

Protein S deficiency is strongly linked to stent thrombosis, occurring in 84.6% of patients versus 16.7% of controls. This finding highlights a potential risk factor for this serious complication after percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Hematology
  • Thrombosis Research

Background:

  • Stent thrombosis is a critical complication of percutaneous coronary intervention (PCI).
  • Predisposing factors are common, yet incidence remains low, suggesting a role for underlying prothrombotic states.
  • A hypothesis suggests a preexisting prothrombotic tendency contributes to stent thrombosis.

Purpose of the Study:

  • To investigate the prevalence of protein C and/or protein S deficiency in patients with stent thrombosis.
  • To determine the association between these deficiencies and the occurrence of stent thrombosis.

Main Methods:

  • Analysis of protein C and protein S levels in 13 patients with stent thrombosis.
  • Comparison with 24 age- and sex-matched control subjects.
  • Assessment of prothrombotic tendency based on protein levels.

Main Results:

  • Protein S deficiency was observed in 84.6% of stent thrombosis patients versus 16.7% of controls (P < 0.001).
  • Protein C deficiency was found in 16.7% of patients and 4.2% of controls (P = 0.25).
  • Combined deficiency of protein C or S occurred in 84.6% of patients vs. 20.8% of controls (P < 0.001). Low protein S was strongly associated with stent thrombosis (OR 3.04).

Conclusions:

  • Protein S deficiency is significantly correlated with stent thrombosis.
  • This previously unrecognized association warrants further investigation.
  • Identifying protein S deficiency may help predict risk for stent thrombosis.
Abstract

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