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Acute and long-term effect of percutaneous coronary intervention on serially-measured oxidative, inflammatory, and coagulation biomarkers in patients with stable angina

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Abstract

To derive insights into the temporal changes in oxidative, inflammatory and coagulation biomarkers in patients with stable angina undergoing percutaneous coronary intervention (PCI). PCI is associated with a variety of biochemical and mechanical stresses to the vessel wall. Oxidized phospholipids are present on plasminogen (OxPL-PLG) and potentiate fibrinolysis in vitro. We recently showed that OxPL-PLG increase following acute myocardial infarction, suggesting that they are involved in atherothrombosis. Plasma samples were collected before, immediately after, 6 and 24 h, 3 and 7 days, and 1, 3, and 6 months after PCI in 125 patients with stable angina undergoing uncomplicated PCI. Plasminogen levels, OxPL-PLG, and an array of 16 oxidative, inflammatory and coagulation biomarkers were measured with established assays. OxPL-PLG and plasminogen declined significantly immediately post-PCI, rebounded to baseline, peaked at 3 days and slowly returned to baseline by 6 months (p < 0.0001 by ANOVA). The temporal trends to maximal peak in biomarkers were as follows: immediately post PCI: OxPL-apoB and lipoprotein (a); Day 1—the inflammatory biomarker IL-6; Day 3—CRP and coagulation biomarkers OxPL-PLG, plasminogen and tissue plasminogen activity; Day 3 to 7—plasminogen activator inhibitor activity, and complement factor H binding to malondialdehyde-LDL and MDA-LDL IgG; Day 7–30 MDA-LDL IgM, CuOxLDL IgM, and ApoB-IC IgM and IgG; >30 days uPA activity, uPA antigen, CuOxLDL IgG and peptide mimotope to MDA-LDL. Most of the biomarkers trended to baseline by 6 months. PCI results in a specific, temporal sequence of changes in plasma biomarkers. These observations provide insights into the effects of iatrogenic barotrauma and plaque disruption during PCI and suggest avenues of investigation to explain complications of PCI and development of targeted therapies to enhance procedural success.

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Funding Sources

This study was funded by the Swiss National Science Foundation PBBSP3-124742 and the Swiss Academy of Medical Sciences PASMP3_132566 (G.L.) and NIH HL119828, HL055798, HL088093, HL106579, HL078610, HL124174. (S.T.).

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Authors and Affiliations

  1. Division of Cardiology, University of Basel, Basel, Switzerland

    Gregor Leibundgut

  2. Division of Cardiology, Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea

    Jun-Hee Lee

  3. Division of Cardiology, St. Michael’s Hospital, Toronto, ON, Canada

    Bradley H. Strauss

  4. Schulich Heart Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada

    Bradley H. Strauss

  5. The Heart Centre, Chaim Sheba Medical Centre, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Amit Segev

  6. Vascular Medicine Program, Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92993-0682, USA

    Gregor Leibundgut & Sotirios Tsimikas

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  1. Gregor Leibundgut
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  2. Jun-Hee Lee
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  3. Bradley H. Strauss
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  5. Sotirios Tsimikas
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Correspondence to Sotirios Tsimikas.

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Dr. Tsimikas is a co-inventor and receives royalties for patents owned by the University of California for the clinical use of oxidation-specific antibodies and currently holds a dual appointment at UCSD and as an employee of Ionis Pharmaceuticals.

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Leibundgut, G., Lee, JH., Strauss, B.H. et al. Acute and long-term effect of percutaneous coronary intervention on serially-measured oxidative, inflammatory, and coagulation biomarkers in patients with stable angina. J Thromb Thrombolysis 41, 569–580 (2016). https://doi.org/10.1007/s11239-016-1351-6

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  • DOI: https://doi.org/10.1007/s11239-016-1351-6

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