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.