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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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Plasma urokinase antigen and C-reactive protein predict angina recurrence after coronary angioplasty

Yelena Parfyonova1, Irina Alekseeva, Olga Plekhanova

  • 1Laboratory of Angiogenesis, Cardiology Research Center, 3rd Cherepkovskaya, 15a, Moscow, 121552, Russia, yeparfyon@yahoo.com.

Heart and Vessels
|September 24, 2013
PubMed

Insights

High preprocedural levels of urokinase plasminogen activator antigen (uPA) and C-reactive protein (CRP) predict angina recurrence after percutaneous transluminal coronary angioplasty (PTCA). These markers can help prognosticate restenosis and guide patient management post-procedure.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Inflammation Research

Background:

  • Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for treating coronary artery disease.
  • Angina recurrence after successful PTCA, often due to restenosis, remains a clinical challenge.
  • Identifying reliable predictors of angina recurrence is crucial for patient management and prognosis.

Purpose of the Study:

  • To evaluate the predictive value of biochemical markers from the coagulation-fibrinolysis system, platelet function, and inflammatory state for angina recurrence post-PTCA.
  • To identify independent predictors of angina recurrence and restenosis following successful elective PTCA.

Main Methods:

  • A cohort of 53 patients with chronic stable angina undergoing successful elective PTCA was studied.
  • Preprocedural and follow-up plasma levels of C-reactive protein (CRP), fibrinogen, urokinase plasminogen activator antigen (uPA), plasminogen activator inhibitor-1 (PAI-1) activity, and tissue plasminogen activator activity were measured.
  • Adenosine diphosphate-induced platelet aggregation was assessed. Patients were followed for 12 months post-PTCA, with angina recurrence as the primary endpoint. Cox proportional hazards models were used for analysis.

Main Results:

  • Sixteen patients experienced angina recurrence within 12 months.
  • Univariate analysis identified duration of stable angina (>12 months), high baseline CRP (>7 mg/l), high baseline and post-PTCA uPA antigen (>1 ng/ml), and high baseline PAI-1 activity (>18 IU/ml) as significant predictors.
  • Multivariate analysis revealed that plasma uPA antigen and serum CRP levels were significant independent predictors of angina recurrence (uPA HR 6.2, CRP HR 1.9).

Conclusions:

  • High preprocedural plasma urokinase plasminogen activator antigen (uPA) and serum C-reactive protein (CRP) levels are significant independent predictors of angina recurrence after successful PTCA.
  • These biochemical markers are valuable for prognostication of restenosis and can aid in clinical decision-making post-procedure.
  • Further research may explore therapeutic strategies targeting these markers to reduce angina recurrence.

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