The Value Of Platelet Surface Expression Of PAC-1, CD62P And Plasma D-dimer In Chronic Heart Failure Patients

Objective:The study was aimed to detect the surface expression of platelet PAC-1(plateletglycoprotein IIb/IIIa receptor), CD62P (P-selection) and the level of plasma D-Dimerin the patients with chronic heart failure (CHF). The correlation was analyzed betweenthe surface expression of platelet PAC-1, CD62P, the level of plasma D-Dimer andN-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejectionfraction(LVEF). The correlation was explored between the severity of CHF and thetrend of thrombosis.Methods:A total of94patients (30cases as control group,64cases as CHF group) wereadmitted into the Fourth Cardiology Department of the Second Affiliated Hospital ofDalian Medical University from July2013to March2014. The CHF group was dividedinto NYHA class II group of15cases, NYHA class III group of24cases, NYHA classIV group of25cases according to the New York heart association (NYHA)classification. According to the etiology, the CHF group was divided into the dilatedcardiomyopathy(DCM)group of15cases, the ischemic cardiomyopathy (ICM) group of19cases, the hypertensive heart disease(HHD)group of15cases, the rheumatic heartdisease(RHD)group of15cases. Two milliliter venous blood was extracted after8hoursfast in all patients. The whole-blood flow cytometry was used to detect the surfaceexpression of platelet PAC-1, CD62P. The level of plasma D-dimer was detected by the STAGO STA-R Evolution analyzer. The statistical analyses were performed usingSPSS18.0statistical software. It was considered statistically significant when P valuewas≤0.05.Results:The surface expression of platelet PAC-1, CD62P and the level of plasma D-dimer in the CHF group were higher than in the control group significantly (P<0.05).The surface expression of platelet PAC-1, CD62P had a rising trend, but no significantdifference was found among NYHA class II group, NYHA class III group, NYHA classIV group (P>0.05). The level of plasma D-Dimer in NYHA class IV group was higherthan in NYHA class II group significantly(P≤0.05). The surface expression of plateletPAC-1in the ICM group was higher than in the DCM group significantly(P<0.05). Nosignificant difference was found in the surface expression of platelet CD62P and thelevel of plasma D-Dimer among the DCM group, the ICM group, the HHD group andthe RHD group. In the CHF patients, the surface expression of platelet PAC-1, CD62Pand the level of plasma D-Dimer were positively correlated with NT-proBNPsignificantly(r=0.389, r=0.351, r=0.253, respectively; all P<0.05). But the surfaceexpression of platelet PAC-1, CD62P and the level of plasma D-Dimer were notcorrelated with LVEF.Conclusion:1.The surface expression of platelet PAC-1, CD62P and the level of plasmaD-Dimer were increased significantly in CHF patients. The examination of the surfaceexpression of platelet PAC-1, CD62P and the level of plasma D-Dimer may contributeto the evaluation of the trend of thrombosis in CHF.2.With the increasing of the level of NT-proBNP, the surface expression of plateletPAC-1, CD62P and the level of plasma D-Dimer were improved gradually. The severerheart failure patients may suffer from the thrombosis easily. The study may provide theevidence for the therapy of antiplatelet and anticoagulation in serious CHF patients.