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Sede
Social
Colegio Oficial
de Médicos
de Barcelona
Paseo de la Bonanova, 47
08017 Barcelona
Telf.: 93 863 02 38
Fax: 93 863 05 58
secretariaseacv@telefonica.net |
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Lunes, 23 de Enero de 2012
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| Publicación
Española del Mes Nº 2 |
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Son las 01:28:52 horas del 5-2-2012 |
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Archivo PDF
(93 KB)
Krupinski J, Catena E, Miguel M, Domenech P,
Vila R, Morchon S, Rubio F, Cairols M, Slevin M, Badimon
L. D-dimer local expression is increased in symptomatic
patients undergoing carotid endarterectomy. Int J Cardiol.
2007;116:174-179.
Cardiovascular Research Center, IIBB/CSIC-HSCSP-UAB,
Barcelona, Spain. krupinski@csub.scs.es.
Factor de impacto de Int J Cardiol = 1.765, según
el Journal Citation Report, 2005.
BACKGROUND: Although atherosclerosis
is a silent widespread disease, the focal character of
the lesions triggering the clinical manifestations is
unquestionable. We hypothesized that symptomatic patients
with advanced, unstable carotid plaques have increased
local intraplaque and circulating levels of fibrin-fibrinogen
related products.
METHODS: Plaque tissue and plasma samples
were studied in 106 patients undergoing endarterectomy
for symptomatic and asymptomatic carotid disease. Fibrin-fibrinogen
related products were evaluated by ELISA, Western-blotting,
and histology. All tested parameters were compared with
patient carotid symptomatology, multiple vascular risk
factors (VRF), bilateral carotid pathology, ultrasound
examination, and previous therapies with statins and/or
antiplatelet drugs.
RESULTS: In symptomatic patients, plasma
D-dimer was elevated in patients with unstable carotid
plaques (UNS) compared with stable (STA) ones (857+/-121
vs. 692+/-156 ng/ml, p=0. 026). Furthermore, plasma D-dimer
was significantly increased in patients with a coexistence
of carotid and coronary artery disease, compared to others
(976+/-325 vs. 714+/-197 ng/ml; p<0.001). Intra-plaque
D-dimer content was increased in ulcerated-complicated
(UC) plaques compared with fibrous non-complicated (F)
plaques in symptomatic patients (5.9+/-1 vs. 1.8+/-1,
p<0.001), and in patients with hypercholesterolaemia,
compared with those with normal cholesterol levels (6.1+/-1
vs. 2.9+/-0.7; p=0.027). However, there was no correlation
between D-dimer content in the carotid plaque and plasma
D-dimer levels.
CONCLUSIONS: Hypercholesterolemia and
UC plaques appear to be associated with high fibrin intraplaque
turnover as demonstrated by higher intraplaque D-dimer.
Plasma markers of fibrin turnover were increased in UNS
plaques, and in patients with coexisting carotid and coronary
artery disease. Although, both plasma and plaque D-dimers
were associated with unstable carotid disease, the usefulness
of the measurement of plasma D-dimer in these patients
should be confirmed by prospective studies. |
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