Platelet Function Monitoring With Sonoclot Analyzer After Double Anti-plateiet Drugs In Different Dose In Coronary Heart Disease Patients

Objectives:Sonoclot coagulation&platelet function analyzer (SCA) was used in this studu to monitor platelet function in the coronary heart disease (CHD) patients who had taken double anti-platelet drugs in different dose.Methods:All candidates were healthy volunteers and inpatients who came from the Affliated Hospital of Medical College of Armed Police Forces between the October2010and March2011.60healthy volunteers are from physical examination center.ranging from41to78years old(57.0±11.0y).34of whom were male.25patients are from vasculocardiology deparment,ranging from40to79years old(61.0±11.0y).12of whom were male.The patients were divided into two groups:group1—15CHD patients who have not recepted coronary intervention in the past years have been taking aspirin(100mg,1/day) all the time.and when they were admitted.they were administrated with both aspirin100mg and clopidogrel300mg;group2—10CHD patients who were firstly diagnosed and never took anti-platelet drugs.and when they were admitted.they were administrated with loading dose of aspirin300mg and clopidogrel300mg.Ali candidates’ blood samples were drawn for routine test and for the Sononclot analysis at the same time. Blood samples were drawn at0h.6h.24h and analyzed with Sonoclot (four channels:Arachidonic acid—AA. Adenosine diphosphate—ADP, Glass beads—gb and non).and each channel involved three variables:activated coagulation time—ACT(s).clot rate—CR (clot signal/min) and platelet function—PF. Statistical analysis were performed with the software package SPSS version13.0.Results:1、All healthy volunteers’blood samples were analyzed by the Sonoclot to define the normal range of the four channels:AA、ADP、non and gb.2、The different groups have double anti-platelet drugs in different dose, after the different therapy, Sonoclot analyzer monitor coagulation and platelet function, evaluate the effects of the anti-platelet drugs, and guide clinical medicine treatment. The result of the group one between drug use and after:(1)、AA channel:compared to0hour,6hour and24hour AA-ACT is prolong、AA-CR is lower(P>0.05), both AA-PF is reduced(P<0.05): compared to6hour,24h AA-ACT is prolonged、AA-CR rised and AA-PF is reduced (P>0.05);(2)、ADP channel:compared to0hour,6hour and24hour ADP-ACT is prolong、ADP-CR is lower and ADP-PF reduced (P<0.05):compared to6hour,24h ADP-ACT is shorten、ADP-CR rised and ADP-PF is reduced (P>0.05);(3)、 non channel:compared to0hour,6hour and24hour non-ACT is prolong、non-PF is reduced (P>0.05), but non-CR is reduced (P<0.05); compared to6hour,24h non-ACT is prolonged、non-CR is reduced and non-PF is reduced (P>0.05);(4)、gb channel:all parameters drug use before and after do not exist significant differences (P>0.05). The result of the group two between drug use and after:(1) AA channel:compared to0hour,6hour and24hour AA-ACT is prolong, AA-CR is lower (P<0.05),6h AA-PF rised (P>0.05),24h AA-PF rised (P<0.05); compared to6hour,24h AA-ACT is shorten and AA-PF rised (P>0.05),、AA-CR rised(P<0.05):(2)、ADP channel:compared to0hour,6hour ADP-ACT is prolong、 ADP-CR is lower (P<0.05), but ADP-PF rised (P>0.05),24hour ADP-ACT is prolong、ADP-CR is lower and ADP-PF rised (P<0.05); compared to6h,24h ADP-ACT is shorten、 ADP-CR rised (P>0.05), but ADP-PF rised (P<0.05)(3)、non channel:compared to Oh,6hour non-ACT is prolong、non-CR is reduced (P<0.05), non-PF rised (P>0.05),24h non-ACT is prolong、non-CR is reduced and non-PF rised (P>0.05):compared to6hour,24h non-ACT is shorten、non-CR rised and non-PF rised (P>0.05):(4)、gb channel:all parameters drug use before and after do not exist significant differences (P>0.05).The result of comparison of group one and healthy volunteers:(1)、AA channel:Oh、6th、24h AA-ACT is shorten (P>0.05); Oh AA-CR is lower (P>0.05):6h and24h AA-CR is lower (P<0.05); Oh、6h and24h AA-PF is lower (P>0.05);(2)、ADP channel:Oh ADP-ACT is shorten (P<0.05),6h、24h ADP-ACT is shorten (P>0.05); Oh ADP-CR rised (P<0.05),6h and24h ADP-CR is lower (P>0.05); Oh ADP-PF rised (P<0.05),6h and24h ADP-PF is lower (P>0.05);(3)、non channel:Oh non-ACT is shorten (P<0.05),6h、24h non-ACT is shorten (P>0.05); Oh non-CR rised (P<0.05),6h non-CR is lower (P>0.05),24h non-CR is lower (P<0.05) Oh non-PF is lower (P>0.05),6h、24h non-PF is lower (P<0.05):(4)、gb channel: all parameters between group one and healthy volunteers do not exist significant differences (P>0.05). The result of comparison of group two and healthy volunteers:(I)、AA channel:Oh、24h AA-ACT is shorten?(P<0.05),6h AA-ACT is shorten (P>0.05);0h、24h AA-CR rised (P<0.05),6h AA-CR rised (P>0.05); Oh、6h and24h AA-PF rised (P<0.05);(2)、ADP channel:Oh ADP-ACT is shorten (P<0.05),6h、24h ADP-ACT is shorten (P>0.05): Oh ADP-CR rised (p<0.05),6h and24h ADP-CR is lower (P>0.05); Oh、6h ADP-PF is lower (P<0.05),24h ADP-PF is lower (P>0.05);(3)、non channel:0h、24h non-ACT is shorten (P<0.05),6h non-ACT is shorten (P>0.05):0h24h non-CR rised (P<0.05),6h non-CR rised (P>0.05):Oh、6h and24h non-PF rised (P<0.05);(4)、gb channel: all parameters between group one and healthy volunteers do not exist significant differences (P>0.05)Conciusion:The present work demonstrated that there is a transient change after dual antiplatelet treatment in coronary heart disease patients. with prolonged AA-ACT. decreased AA-CR and prolonged ADP-ACT. decreased ADP-CR.This trend demonstrated that the platelet induced the activation of the coagulation process performed a transient weakening change in the CHD patients.which is the guideline for CHD patients who receive anti-platelet treatment.and make further assessment of excessive anti-platelet.anticoagulation and the risk of hemorrhage.