Abstract
Background: Recent observation suggest that thrombosis in vivo is initiated via the issue factor (TF) pathway. The TF activity of human coronary atheroma has not been reported. Methods and results: Directional coronary atherectomy (DCA) specimens from 63 lesions were analyzed with the use of a quantitative TF-specific activity assay. The median content TF was 10 ng/g plaque (95% Cl, 6 to 13 ng/g; range, 0 to 47 ng/g). After homogenization of the specimens, TF activity was detected in 28 of 31 lesions (90%). With a polyclonal anti-human TF antibody, the use of immunohistochemistry detected TF antigen in 43 of 50 lesions (86%); TF antigen was expressed in cellular and cellular areas of the plaque. Histologically defined thrombus was present in 19 of the 43 lesions with detectable TF antigen and in none of the 7 lesions without detectable TF antigen (19 of 43 versus 0 of 7; P<.02). TF antigen was undetectable with immunohistochemistry of 4 of restenotic lesions (31%) and in 3 of 37 de novo lesions (8%) (P<.05). Conclusions: TF contributes to the procoagulant activity of most atherosclerotic lesions treated with DCA. The association of immunohistochemically detectable TF with plaque thrombus suggest that TF plays a role in coronary thrombosis. Diminished TF expression in restenotic lesions may in part account for the lower complication rate that has been associated with DCA of restenotic versus de novo lesions. Inhibition of TF may represent a therapeutic goal for the prevention of thrombotic complications associated with percutaneous coronary interventions.
Original language | English |
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Pages (from-to) | 1226-1232 |
Number of pages | 7 |
Journal | Circulation |
Volume | 94 |
Issue number | 6 |
DOIs | |
State | Published - 1996 |
Keywords
- angioplasty
- coronary disease
- immunohistochemistry
- thrombosis
- thrombus