Background: This study sought to examine whether circulatory levels of endothelial dysfunction biomarkers [vascular cell adhesion molecule (sVCAM-1), intercellular adhesion molecule (sICAM-1), sE-selectin, von Willebrand factor (vWF), tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1)] are associated with occurrence of late or very late stent thrombosis (ST) after percutaneous coronary intervention with sirolimus-eluting stent implantation, and to assess the possible influence of genetic variants of these proteins on ST.
Methods: Serum levels of sVCAM-1, sICAM-1, sE-selectin, vWF, t-PA and PAI-1 were measured, and polymorphisms of vWF (-1234C/T, -1185A/G and -1051G/A), t-PA (insertion/deletion) and PAI-1 genes (4G/5G) were determined in 41 patients who experienced at least one episode of late or very late ST. Eighty-two patients without ST randomly selected from the same study period served as controls.
Results: Serum levels of vWF, sVCAM-1and sICAM-1 were significantly increased in patients with ST than in controls (all P<0.01). No significant difference was observed in the genotype and allele distribution of the vWF, t-PA and PAI-1 gene polymorphisms. Multivariable logistic regression analysis showed that vWF, sVCAM-1, discontinuation of clopidogrel therapy and left ventricular ejection fraction of less than 50% were independent determinants of late ST.
Conclusion: Increased serum vWF and sVCAM-1 levels are associated with late ST, suggesting that endothelial dysfunction contributes to the development of late or very late ST.
aDepartment of Cardiology, Rui Jin Hospital, Medical School of Jiaotong University
bInstitute of Cardiovascular Diseases, Medical School of Jiaotong University, Shanghai, PR China
Correspondence to Professor Wei Feng Shen, MD, PhD, Department of Cardiology, Rui Jin Hospital, 197 Rui Jin Road II, Shanghai 200025, PR China
Tel: +8621 6437 0045 610910; fax: +8621 6433 7177;
Cao Jin and Lin Lu are co-first authors
Received 24 March 2010 Accepted 19 April 2010