Abstract:

To investigate the relationship between plasminogen activatorinhibitor-1 (PAI-1) 4G/5G gene polymorphism and  homeostatic activation after percutaneous coronary intervention（PCI），and provide foundation for clinic  detection of thrombosis after PCI.Methods The plasma von Willebrand factor（vWF）,activated factor Ⅶ ( FⅦc) ,PAI-1 activities and GMP-140, D-dimers(D-D)  levels in 86 patients with coronary heart disease undergoing in-stent implantation were determined before and immediate postoperative,and 24 h after PCI.PAI-1 gene polymorphism was detected by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) to observe the changes of platelet function and coagulation and fibrinolytic states before and after PCI.Results The distribution of PAI-1 genotypes was as follows:48 cases with 4G/4G (56%),30 cases with 4G/5G (35% )and 8 cases with 5G/5G ( 9%).Among the patients,the allelic frequencies of 4G and 5G  were 73% and 27% respectively.No significant difference of the plasma GMP-140,vWF,FⅦa,D-D and PAI-1 levels was found between the three genotypes before PCI (P>0.05).In the patients with  4G/4G polymorphism of PAI-1 gene,the GMP-140,vWF,FⅦa,D-D and PAI-1 levels in plasma were significantly increased at  immediate postoperative period(P<0.01).The PAI-1 levels in plasma were significantly increased 24 h after PCI(P< 0.01);but the GMP-140,vWF,FⅦa and D-D  levels did not significantly increase (P>0.05).In the patients with 4G/5G and 5G/5G genotypes, all indexes mentioned above were significantly increased at  immediate postoperative period (P<0.01);24 h after PCI there were no significant differences (P>0.05).In the patients with 4G/4G genotype, the PAI-1 level in plasma was significantly higher than those in the patients with 4G/5G and 5G/5G genotypes 24 h after PCI(P< 0.01).
Conclusion There is a remarkable homeostatic activation and the fibrinolytic activity changes more in patients with 4G/4G genotype than  those in patients with  4G/5G and 5G/5G genotypes after PCI.The results suggest that the patients with 4G/4G genotype may be a dangerous factor in acute or subacute coronary thrombosis after PCI

Key words: percutaneous coronary intervention, polymorphism, single nucleotide； plasminogen activator inhibitor-1;GMP-140;factor Ⅶ;D-Dimer