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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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Plasma fibrinogen levels and restenosis after primary percutaneous coronary intervention

Alessandro Lupi1, Gioel Gabrio Secco, Andrea Rognoni

  • 1Cardiologia Ospedaliera, Ospedale Maggiore della Carità, Corso Mazzini 18, Novara, Italy. lupialessandro1@tin.it

Journal of Thrombosis and Thrombolysis
|September 13, 2011
PubMed

Insights

High plasma fibrinogen levels are linked to in-stent restenosis after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients. This finding suggests fibrinogen may predict restenosis risk in this acute cardiac setting.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Biomarkers

Background:

  • Plasma fibrinogen levels are known to influence restenosis after elective percutaneous coronary intervention (PCI) for stable angina.
  • The association between fibrinogen levels and restenosis in the context of primary PCI for ST-elevation myocardial infarction (STEMI) remains unclear.

Purpose of the Study:

  • To investigate the relationship between plasma fibrinogen levels and 6-month in-stent restenosis (ISR) in STEMI patients who underwent successful primary PCI.
  • To determine if elevated fibrinogen is an independent predictor of ISR in this patient population.

Main Methods:

  • A cohort of 171 STEMI patients treated with primary PCI were enrolled.
  • Plasma fibrinogen levels were measured at multiple time points: admission, 12, 24, 48, 72 hours post-PCI, and at discharge.
  • Six-month angiographic follow-up was performed to assess for ISR.

Main Results:

  • Patients with 6-month ISR exhibited significantly higher plasma fibrinogen levels compared to those without ISR.
  • A higher incidence of symptoms and/or inducible myocardial ischemia (27.1% vs. 7.1%) and greater late lumen loss (1.3 vs. 1.0 mm) were observed in the highest fibrinogen tertile.
  • Logistic regression analysis confirmed a significant and independent association between fibrinogen levels and ISR.

Conclusions:

  • Increased plasma fibrinogen levels are associated with an elevated risk of in-stent restenosis in STEMI patients undergoing primary PCI.
  • Fibrinogen may serve as a potential biomarker for predicting ISR in this acute coronary syndrome setting.
  • Further research with larger cohorts is recommended to evaluate the prognostic value of fibrinogen for harder clinical endpoints.

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