Endothelial dysfunction parameters in the prognosis of cardiovascular complications after percutaneous coronary interventions

Abstract

Summary. Aim: to study the effect of endothelial function on the percutaneous coronary interventions (PCI) outcomes during the mid-term follow-up period. Materials and Methods. The observational study included 116 patients after elective PCI. The patients were divided into 2 groups: group 1 (n=28) with adverse cardiovascular events (АCЕs) in the medium-term after PCI and group 2 (n=88) without АCЕs. Soluble vascular cell adhesion molecule type 1 (sVCAM-1) level, the activity of von Willebrand factor (vWF) and physiological anticoagulants, including antithrombin, protein C, protein S and troponin I were analyzed before PCI, on the next and day 10, than after 1, 3, 6, and 12 months after endovascular intervention. Results. One day after PCI, a significant increase in sVCAM-1 expression was observed, which amounted to 1219.35±59.25 ng/ml in group 1 and 855.7±59.8 ng/ml in group 2 (p=0.0001), an increase in vWF activity (in group 1 — 172.7 ± 6.07%, in group 2 — 145.5 ± 8.45%; p = 0.005), a decrease in the activity of protein C and anti- thrombin in group 1 (p=0.0001). In both groups after PCI, an increase in the concentration of free protein S was observed after 6 months (in group 1 — 132.5 ± 11.69%, in group 2 — 113.8 ± 8.72%; p > 0.05) and after 12 months (in group 1 — 177.2 ± 16.11%, in group 2 — 182.3 ± 16.87%; p > 0.05). Predictors of ACEs after PCI were the activities of vWF and antithrombin. Conclusion. The leading role in ACEs pathogenesis after PCI is attributed to the endothelial dysfunction with the loss of thromboresistance properties by the endothelium and increased blood thrombogenic potential.

For citation: Buziashvili Yu.I., Tetvadze I.V., Kirtbaia L.N. Endothelial dysfunction parameters in the prognosis of cardiovascular complications after percutaneous coronary interventions. Tromboz, gemostaz i reologiya. 2026;(1):85–92. (In Russ.).

References 

1. Avdonin P.P., Tsvetaeva N.V., Goncharov N.V. et al. Von Willebrand factor in health and disease. Biologicheskie membrany: Zhurnal membrannoj i kletochnoj biologii. 2021;38(4):237–56. (In Russ.).
2. Boos C.J., Balakrishnan B., Jessani S. et al. Effects of percutaneous coronary intervention on peripheral venous blood circulating endothelial cells and plasma indices of endothelial damage/dysfunction. Chest. 2007;132(6):1920–6. DOI: 10.1378/chest.07-1693.
3. Boos C.J., Lip G.Y., Blann AD. Circulating endothelial cells in cardiovascular disease. J Am Coll Cardiol. 2006;48(8):1538–47. DOI: 10.1016/j.jacc.2006.02.078.
4. Vargova K., Toth-Zsamboki E., Beres B.J. et al. Circulating endothelial cell count, plasma vWF and soluble ICAM-1 levels following primary or elective percutaneous coronary intervention. Atherosclerosis. 2008;198(2):366–72. DOI: 10.1016/j.atherosclerosis.2007.09.005.
5. Alekseeva I.V., Urazgildeeva S.A. Functional heterogeneity of the von Willebrand factor: pathogenetic significance and practical aspects of use in cardiology. Kardiologiya. 2022;62(7):54–60. (In Russ.). DOI: 10.18087/cardio.2022.7.n1641.
6. Chung D.W., Chen J., Ling M. et al. High-density lipoprotein modulates thrombosis by preventing von Willebrand factor self-association and subsequent platelet adhesion. Blood. 2016;127(5):637–45. DOI: 10.1182/blood-2014-09-599530.
7. Kozlov S., Okhota S., Avtaeva Y. et al. Von Willebrand factor in diagnostics and treatment of cardiovascular disease: Recent advances and prospects. Front Cardiovasc Med. 2022;9:1038030. DOI: 10.3389/fcvm.2022.1038030.
8. Pelliccia F., Zimarino M., Niccoli G. et al. In-stent restenosis after percutaneous coronary intervention: emerging knowledge on biological pathways. Eur Heart J Open. 2023;3(5): oead083. DOI: 10.1093/ehjopen/oead083.
9. Liu W., Wang X., Feng Y. Restoring endothelial function: shedding light on cardiovascular stent development. Biomater Sci. 2023;11(12):4132–50. DOI: 10.1039/D3BM00390F.
10. Clare J., Ganly J., Bursill C.A. et al. The mechanisms of restenosis and relevance to next generation stent design. Biomolecules. 2022;12(3):430. DOI: 10.3390/biom12030430.
11. Gori T. Restenosis after coronary stent implantation: cellular mechanisms and potential of endothelial progenitor cells (a short guide for the interventional cardiologist). Cells. 2022;11(13):2094. DOI: 10.3390/cells 11132094.
12. Fan M., Wang X., Peng X. et al. Prognostic value of plasma von Willebrand factor levels in major adverse cardiovascular events: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2020;20(1):72. DOI: 10.1186/s12872-020-01375-7.
13. Tscharre M., Tentzeris I., Vogel B. et al. Von Willebrand factor and ADAMTS13 and long-term outcomes in patients undergoing percutaneous coronary intervention. Thromb Res. 2020;196:31–7. DOI: 10.1016/j.thromres.2020.08.018.