Effects Of Low Molecular Weight Heparin And Unfractionated Heparin On VWF,D-dm And CD62P In Patients With Unstable Angina

Objective: To observe the effects of low molecular weight heparin(LMWH) and unfractionated heparin(UFH) on plasma v\\^ D-dm and CD62P on platelet membrane in patients with unstable angina(UA), compare the efficacy of LMWH and UFH in UA, and to evaluate the prognostic value of vWF> D-dm and CD62P in acute coronary events.Methods: 50 patients with UA were randomized to receiving LMWH(LMWH group) and UFH(UFH group) for one week. Blood was sampled twice in each patient at admission and at seventh day. The plasma concentrations of vWF and D-dm were measured in duplicate with enzymelinked immunosorbent assay(ELISA) technique. The level of CD62P was mersured with flow cytometry technique. The changes of electrocardiogram(ECG), quantity of using nitroglycerin, frequence of angina and cardiac events in seven days were observed. In addition, cardiac events in 30 days after admission were also followed up.Results: The level of vWF D-dm and CD62P were not significantly different between the two groups at admission. The plasma concentrations of vWF^ D-dm and the expressionlevel of CD62P in LMWH group were significantly decreased after treatment(P<0.05) . In UFH group, the levels of vWF and D-dm were significantly decreased after treatment(P<0.01), but the change of CD62P was not evident(P>0.05). After treatment, the level of vWF in LMWH group was significantly lower than that in UFH group(P<0.05), but the levels of D-dm and CD62P were not significantly different between the two groups(P>0.05).After the 50 patients were stratified by risk factors, the levels of vWF D-dm and CD62P in the high risk group was highest at admission(P<0.01), but they were not significantly different between the medium risk group and the low risk group(P>0.05). The levels of vWF D-dm and CD62P were significantly higher in patients with cardiac events than in those without cardiac events(P<0.05).The composite end point of death, MI or revascularization in seven days and in 30 days was lower in LMWH group (7days, 4%; 30days, 12%) than in UFH group (7days, 12%; SOdays, 24%).onclusion: In summary, the efficacy of LMWH is superior to UFH in acute phase of UA. The significantly increased levels of vWF^ D-dm and CD62P in acute phase of UA can be used to distinguish risk stratification and served as the predictive factor of acute coronary events. Plasma vWF could be acted as a new curing target for antithrombotic in clinic in future.