Plasma fibrinogen as a risk factor for restenosis after percutaneous transluminal renal angioplasty in patients with atherosclerotic renal artery stenosis.

摘要

BACKGROUND: In contrast to those for coronary restenosis, the data regarding the risk factors for renal restenosis are limited. OBJECTIVE: To evaluate potential humoral risk factors for restenosis after percutaneous transluminal renal angioplasty (PTRA). METHODS: We studied 27 patients aged 54+/-10 years with atherosclerotic renal artery stenosis in a 1-year prospective follow-up. Restenosis (confirmed by angiography) occurred in eight patients 1-6 months after PTRA. We detected no Doppler ultrasound evidence of restenosis in 19 patients throughout 1 year. Blood studies were done before PTRA for all patients, at the time of diagnosis of restenosis and, for those without restenosis, after 1 year. including determinations of fibrinogen, lipids, platelets and leukocytes. RESULTS: The mean level of fibrinogen in patients who experienced restenosis was higher than that in those who did not (450+/-150 mg% versus 337+/-57 mg%, P < 0.01) and remained unchanged for both groups during follow-up. The other parameters did not differ between the groups before PTRA and did not change over time, with the exception of platelet count in patients who did not experience restenosis, which had decreased from 253+/-93G/l to 200+/-63G/l (P < 0.01) 1 year after PTRA. The logistic multiple regression analysis disclosed that an increment of fibrinogen level by 100 mg% was linked with an odds ratio for restenosis of 3.2 (95% confidence interval 1.1-9.8). CONCLUSIONS: Restenosis was associated with higher than normal levels of fibrinogen before PTRA. A high plasma fibrinogen level might play a role in the development of restenosis after PTRA.