Abstract
Background: Although acceleration of plasma plasminogen activator inhibitor‐1 (PAI‐1) level after emergent coronary angioplasty in acute myocardial infarction (AMI) has been documented, its pathophysiologic role is still unknown.
Hypothesis: This study was designed to elucidate the role of PAI‐1 in the development of restenosis after primary coronary stenting in AMI.
Methods: We selected for this study 66 patients with AMI, who underwent primary coronary stenting for infarct‐related coronary artery lesions in an emergent situation. In all patients, plasma PAI‐1 level was measured at admission, and at 3 h, 24 h, 48 h, and 1 month after coronary stenting.
Results: At admission, the PAI‐1 level was equivalent in 24 patients who experienced restenosis and in 42 patients without restenosis (28 ± 4 vs. 29 ± 4 ng/ml). In patients with restenosis, the levels did not change during the course after coronary stenting. In patients without restenosis, however, the level significantly increased at 3 h (48 ± 9 ng/ml, p < 0.001), 24 h (42 ± 9, p < 0.01), and 48 h (38 ± 7, p < 0.05) after coronary stenting, and was restored to the level equivalent to that at admission (27 ± 2 ng/ml) 1 month after coronary stenting. The PAI‐1 level at 3 h after coronary stenting in patients without restenosis was significantly higher (p < 0.05) than the level (33 ± 6 ng/ml) in patients with restenosis. Multiple logistic regression analysis indicated that the PAI‐1 level 3 h after coronary stenting was an independent predictor of restenosis (Wald x2 = 3.826, p = 0.019, odds ratio 0.921, 95% confidence interval 0.866‐0.961).
Conclusion: Accelerated PAI‐1 after coronary stenting in patients with AMI may protect against the development of late restenosis.
Keywords: acute myocardial infarction, plasminogen activator inhibitor‐1, coronary stent, restenosis
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