Correlation Of The Plasma Soluble Thrombmodulin And Endothelialization After Coronary Stent Implantation

Object Percutaneous Coronary Intervention(PCI)has been an effective therapeutic method for curing coronary atherosclerotic heart disease nowadays. Drug-eluting stent(DES) can reduce the incidence of In-stent restenosis, but at the risk of vascular endothelialization delay, endothelium dysfunction,and the increase of stent thrombosis. Previous research has confirmed that Optical coherence tomography(OCT) images can display the stage of vascular endothelialization. However, on account of the problems of costs and technology, finding a quick and convenient indicator to reveal the status of vascular endothelialization after PCI is considerable important. Soluble thrombomodulin(s TM) is considered a gold standard of endothelial damage,but no studies have confirmed its change of expression after PCI.Our study is to investigate the relationship between the plasma soluble thrombmodulin and endothelialization after coronary stent implantion,and the guiding significance of the clinical medication using time of ADP receptor antagonists.Methods Analyze the clinical data of the 32 patients with coronary artery disease who on follow up angiography had no restenosis at 12~18 months after drug-eluting stent(DES) in Department of Cardiology of Jining Medical College Affiliated Hospital. Optical coherence tomography(OCT) images were got in the above 32 patients’ 32 stents. Patients whose struts with complete endothelialization were regarded as complete endothelialization group, patients whose DES struts with incomplete endothelialization were considered as incomplete endothelialization group, healthy patients with nomal coronary were regarded as the control group. Double antibody sandiwich enzyme linked immunosorbent assay(ELISA) was used to detect the serum levels of the plasma s TM from their venous. Then analyze the relationship between the plasma soluble thrombmodulin and endothelialization after coronary stent implantion.Results1. The plasma s TM levels of complete endothelialization group, incomplete endothelialization group and the control group 5.25±1.62 were ug/l, 7.98±1.43ug/l and 5.21±1.55ug/l. 2. The levels of plasma s TM in incomplete endothelialization group were dramatically higher than the complete control group and the endothelialization group(P<0.05),the plasma s TM levels had no apparently difference in the control group and the complete endothelialization group(P>0.05). 3. Plasma s TM level and the uncovered stent struts was positively correlated with each other(r = 0.733).Conclusions 1. The plasma s TM levels had no significant difference in the control group and the complete endothelialization group. 2. Plasma s TM level and the uncovered stent struts was positively correlated with each other. 3. To some extent, for the coronary artery disease patients who had DES implanted, the plasma s TM level can guide how long the antiplatelet therapy should be continued.