| Backgrounds and PurposesAtherosclerosis is the most common cause of coronary heart disease, and the splitting of atheromatous plaque, dissections and fibrous tissue rupture, the abrasion of the endothelium and the rupture of the plaque expose fatty plaque (which contains tissue factor), all of which can induce activation of the platelets and coagulation, these are the pathology of acute coronary syndromes (ACS). Percutaneous transluminal coronary angioplasty and stent implantation (PTC A+Stent) is one of the percutaneous coronary interventions (PCI) ways treated ACS, and it has almost replaced the operation on ACS patients, because it is safer, more effective, less traumatic, and is repeatable compared with coronary artery bypass grafting (CABG). However, acute and subacute thrombuses of the vessel threaten the success of the procedure, so the antiplatelet and anticoagulant drugs are used to prevent the formation of acute and subacute thrombuses. But till now, the changes of platelet and coagulation activation after PTCA+Stent with the use of antiplatelet and anticoagulant drugs didn't know. The aim of this study is to measure the plasma platelet alpha- granule membrane glycoprotein 140 (GMP-140), fibrinopeptide A (FPA) and prothrombin time (PT) in ACS patients when they were admitted and 3 days after PCI, and observe their/changes with using aspirin, ticlopidine and low molecular weight heparin (LMWH) conventionally.Methods32 consecutive ACS patients who underwent PTCA+Stent were enrolled in this study, and patients with history of bleeding peptic ulcer, known intolerance for any one of the studied drugs, treatment with drugs influencing the haemostatic system, concomitant malignant disease, acute infection, diseases in liver or kidney, brain vessels diseases and immunity system diseases were excluded. All patients were divided into 2 groups-acute myocardial infarction (AMI) group (n=15) and unstable angina pectoris (UAP) group (n=17) according to the cause of disease. 15 patients with normal angiocardiograph (CAG) results in the control group, the diagnosises were hypertension (3 cases), chronic gastritis (1 case), arrhythmia (1 case), gastroesophageal reflex disease (5 cases) or hypertrophic cardiomyopathy (3 cases).Additionally, conventional therapy including nitrates or 3 -blockers were continued without any changes. All the patients received aspirin 300mg/day and ticlopidine 500mg/day for 3 days before PCI, then aspirin and ticlopidine were orally taken continuously with LMWH 0.25ml hyodermicly twice a day after PCI. The way of PTCA+Stent was standard.Blood for the measurement of platelet activation (GMP-140) and coagulation function (FPA, PT) were collected at 5 AM from peripheral vein in order to avoiding the possible influence of circadian variation on the indexes.Immediately after collection the blood was placed in three plastic tubes, one containing 0.3ml of EDTA anticoagulant used for GMP-140 measurements was centrifuged at 1500r/min for 10 min; one containing 0.3ml of FPA anticoagulant used for FPA measurements was centrifuged at 3000r/min for 10 min and then treated with bentonite to remove fibrinogen; the last one containing 0.3ml of natrium citricum anticoagulant for PT was centrifuged at 3000r/min for 5 min, and all samples were stored at -70C until the assay. The plasma levels of FPA, GMP-140 were measured by a commercially available enzyme-linked immunosorbent assay (ELISA) kit, andClauss method was used for PT.The results were expressed as mean standard deviation (SD) and data from ACS patients were analyzed by Student's t-test. Linear correlation analysis was used to determine the correlation between FPA and GMP-140. Statistical analysis were performed using a SAS6.12 package. P values less than 0.05 were considered statistically significant.Results1. There were no significant difference in blood lipid, blood glucose and blood platelet among the UAP group, AMI group and control group (P>0.05) .2. When the patients were admitted, the levels of F...
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