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Related Collections Hemostasis, Thrombosis, and Vascular Biology Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 April 2002, Vol. 99, No. 8, pp. 2794-2800 HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY Coronary no-reflow is caused by shedding of active tissue factor from dissected atherosclerotic plaque Diana Bonderman, Alexander Teml, Johannes Jakowitsch, Christopher Adlbrecht, Mariann Gyöngyösi, Wolfgang Sperker, Harald Lass, Wilhelm Mosgoeller, Dietmar H. Glogar, Peter Probst, Gerald Maurer, Yale Nemerson, and Irene M. Lang From the Department of Cardiology, University of Vienna; the Ludwig Boltzmann Institute for Cardiovascular Research; the Institute for Molecular Oncology, Vienna, Austria; and the Mount Sinai School of Medicine, New York, NY. Defined angiographically, no-reflow (NR) manifests as an acute reduction in coronary flow in the absence of epicardial vessel obstruction. One candidate protein to cause coronary NR is tissue factor (TF), which is abundant in atherosclerotic plaque and a cofactor for activated plasma coagulation factor VII. Scrapings from atherosclerotic carotid arteries contained TF activity (corresponding to 33.03 ± 13.00 pg/cm2 luminal plaque surface). Active TF was sedimented, indicating that TF was associated with membranes. Coronary blood was drawn from 6 patients undergoing coronary interventions with the distal protection device PercuSurge GuardWire (Traatek, Miami, FL). Fine particulate material that was recovered from coronary blood showed TF activity (corresponding to 91.1 ± 62.16 pg/mL authentic TF). To examine the role of TF in acute coronary NR, blood was drawn via a catheter from coronary vessels in 13 patients during NR and after restoration of flow. Mean TF antigen levels were elevated during NR (194.3 ± 142.8 pg/mL) as compared with levels after flow restoration (73.27 ± 31.90 pg/mL; P = .02). To dissect the effects of particulate material and purified TF on flow, selective intracoronary injection of atherosclerotic material or purified relipidated TF was performed in a porcine model. TF induced NR in the model, thus strengthening the concept that TF is causal, not just a bystander to atherosclerotic plaque material. The data suggest that active TF is released from dissected coronary atherosclerotic plaque and is one of the factors causing the NR phenomenon. Thus, blood-borne TF in the coronary circulation is a major determinant of flow. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Mayr, D. Grainger, U. Mayr, A. S. Leroyer, G. Leseche, A. Sidibe, O. Herbin, X. Yin, A. Gomes, B. Madhu, et al. 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