The Role of Fibrinogen, Lipoprotein (a) and C-Reactive Protein in Acute Thrombotic Occlusion after Percutaneous Coronary Intervention

Background:Acute thrombotic occlusion after percutaneous coronary intervention (PCI) is a serious complication that provokes acute myocardial infarction, cardiac death or emergency bypass surgery. The role of fibrinogen, C-reactive protein (CRP) and lipoprotein (a)[Lp(a)] in patients who developed acute thrombotic occlusion after PCI was investigated. Methods:The patients with acute coronary syndrome who had undergone PCI at Chonnam National University Hospital between Jan. 1999 and Jun. 2000 were divided into two groups according to the occurrence of acute thrombotic occlusion:Group I patients with thrombotic occlusion after PCI (62.3±8.8 years, M:F ratio=19:8) and Group II patients without thrombotic occlusion after PCI (59.6±10.6 years, M:F ratio=271:95). Clinical and angiographic characteristics, as well as the levels of fibrinogen, CRP and Lp (a), were compared between the two groups. Results:There was no significant differences in the level of fibrinogen between the two groups. Elevation of CRP level (>0.5 mg/dL) occurred more commonly in Group I patients than in Group II (88.9% vs. 42.3%, p=0.0001) and the average value of CRP was higher in Group I than in Group II (4.97±5.18 mg/dL vs. 2.27±4.23 mg/dL, p= 0.002). High Lp (a) level (>30 mg/dL) was also more prevalent in Group I patients than in Group II (44.4% vs 18.6%, p=0.001). There were no significant differences in the risk factors for coronary artery disease, except for diabetes mellitus (Group I:Group II, 40.7%:16.9%, respectively, p=0.002). Thrombolysis in Myocardial Infarction (TIMI) flow of Group I was lower than in Group II (p=0.0001). After the adjustment for age, sex and other cardiovascular risk factors, multiple regression analysis revealed that diabetes mellitus, low TIMI flow, high CRP and high Lp (a) were independently associated with the 논문접수일:2001년 4월 23일 심사완료일:2001년 5월 28일 교신저자:정명호, 501-757 광주광역시 동구 학1동 8번지 전남대학교병원 심장센터 전화:(062) 220-6243·전송:(062) 228-7174 E-mail: myungho@chollian.net