Plasma Level of Hepatocyte Growth Factor (HGF) after Percutaneous Coronary Intervention (PCI) Is a Useful Predictor of Restenosis
Jun Tateishi,
Hyogo College of Medicine, Nishinomiya, Japan

Hepatocyte growth factor (HGF) is a potent endothelium-specific growth factor with mitogenic activity that has been shown to reach elevated levels in plasma following endothelial injury. In this study, the rise in plasma HGF levels, which peaked 12 hours after percutaneous coronary intervention (PCI, was shown to correlate with development of restenosis at 6-month follow-up.

Hepatocyte growth factor (HGF) is a potent endothelium-specific growth factor with marked mitogenic activity. Plasma levels of HGF have been shown to rise in response to various endothelial stresses, including hypertension-induced endothelial damage. When coronary artery restenosis occurs, it is caused in part by a shift in the balance between growth inhibition and promotion toward the promotion of growth of vascular smooth muscle cells (VSMC). Because percutaneous coronary intervention (PCI) creates acute endothelial injury and one of the main factors contributing to restenosis is a growth factor-mediated increase in VSMC growth, it was hypothesized that an increase in HGF following PCI may contribute to restenosis.

Study design had two goals: to determine whether HGF plasma levels rise after PCI, and, if this occurs, whether the rise in HGF level is associated with post-procedural restenosis. Because HGF levels are known to rise following administration of heparin, study patients received argatroban, a thrombin inhibitor, rather than heparin in conjunction with their PCI procedures. Of 55 consecutive patients undergoing PCI for coronary artery occlusion, 9 received heparin and 46 received argatroban. The results demonstrated that the steep rise in HGF levels immediately following heparin administration (40-fold compared with baseline level) did not occur following argatroban administration.

The 46 patients who received argatroban as an anticoagulant were evaluated 6 months after their PCI procedures. Within that group, 17% of patients had angiographic evidence of restenosis. There was a significant correlation between the elevation in plasma HGF levels 12 hours following PCI and the presence of restenosis 6 months later. Conclusion: An increment in plasma HGF of >0.3 ng/mL at 12 hours after PCI (when performed with argatroban rather than heparin) compared with the baseline HGF level may predict the development of restenosis [p = 0.04; odds ratio = 3.93 (95% CI = 14.2 - 1.09)].


Reporter: Andre Weinberger, MD


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