Related Research Of Resting Heart Rate And Platelet Activity And Comparison Of Platelet Function Testing Methodology

Objective:To analyze the relationship between resting heart rate and platelet activity in patients with coronary heart disease and the correlation of light transmission aggregometry(LTA), thromboelastography(TEG) and PL-11 automatic platelet analyzer.Methods:1.1056 cases of patients admitted in our hospital were selected. According to the heart rate was divided into four groups:heart rate lower than 60bpm group(n=110), heart rate between 61bmp and 69bmp group(n=254), heart rate between 70bmp and 79bmp group(n=420), heart rate higher than 80bpm group(n=272).292 cases of patients admitted in our hospital were selected. According to the disease priorities was divided into three groups:acute myocardial infarction group(n=70), unstable angina group(n=134) and stable angina group(n=88).2. According to the heart rate patients were accepted A A inhibition ratio and ADP inhibition ratio and MA value、MA-ADP value and MA-AA value, which is included in TEG testing. Compare the difference of MA、MA-ADP、MA-AA value and AA inhibition ratio and ADP inhibition ratio in different heart rate patients. Follow-up for one month to observe the adverse events occurrence rate and the relationship with the platelet activity.3. According to the disease priorities patients were accepted LTA,TEG and PL-11 three kinds of platelet function testing, and follow-up for one month. To analyze the correlation of three kinds of platelet function testing and to observe adverse events occurrence rate in patients and the relationship with platelet activity.Results:1. The MA value in heart rate lower than 60bpm group(G1), heart rate between 61bmp and 69bmp group(G2), heart rate between 70bmp and 79bmp group(G3)and heart rate higher than 80bpm group(G4) were 63.01 ±5.98mm、63.52±6.02mm、 64.45±6.49mm、65.43±7.49mm. Compared MA in G4 group with G1,G2 or G3 group, significant differences were existed between them(P<0.05). Therer were no significant difference between four groups on MA-ADP value(31.67±14.99mm vs 31.78±17.07mm vs 33.30±17.03mm vs 33.07±17.56mm, P>0.05). There were significant difference between four groups on MA-A value(18.86±14.92mm vs 17.73 ±13.81mm vs 20.76±16.32mm vs 21.66±16.29mm, P<0.05). AA-induced platelet inhibition ratio of TEG in four group were82.64±26.24%、85.30±24.35%、81.23 ±27.70%、81.70±25.97%. ADP-induced platelet inhibition ratio of TEG in four group were 60.20±26.58%、61.39±29.88%、59.28±28.81%、60.08±29.21%. There were no statistically significant difference on AA or ADP induced inhibition ratio between four groups(P>0.05). After follow-up for one month, the adverse events occurrence rates in three groups were 13.64%,13.39% and 23.91%, respectively. Significant differences were existed between three groups(P<0.05). There were no statistically significant difference on MA between adverse events occurrence group and no adverse events occurrence group(64.26±0.59mm vs 64.22±0.21mm, P>0.05). There were statistically significant difference on MA-ADP between two groups(37.31 ±1.30mm vs 33.27±0.59mm, P<0.05). There were statistically significant difference on MA-AA between two groups(24.66±1.26mm vs 20.80±0.56mm, P<0.05). There were statistically significant difference on ADP IR% between two groups(51.62± 2.10% vs 61.37±0.95%, P<0.05). There were statistically significant difference on AA IR% between two groups(74.90±2.05% vs 83.29±0.85%, P<0.05).2. The MA value in acute myocardial infarction group, unstable angina group and stable angina group were 69.02±5.82mm、65.66±5.19mm、64.44±5.61mm. Compared MA in acute myocardial infarction group with unstable angina group or stable angina group, significant differences were existed between them(P<0.05). The MA-ADP value in three groups were 36.68±15.94mm、33.25±16.36mm、35.53± 17.20mm, the MA-AA value in three groups were 20.73±13.31mm、19.47± 15.38mm、20.83±17.80mm, there were no significant differences in MA-ADP or MA-AA between three groups(P>0.05). Different platelet testing ways ADP-induced platelet aggregation were:(1) LTA-ADP%:33.03 ±20.63%、35.83±22.02%、41.09 ± 21.14%, there were no significance between three groups(P>0.05); (2) PL-11-ADP%:37.33±16.27%、38.62±17.26%.42.04±15.10%, there were no significance between three groups(P>0.05); (3) TEG-ADP%:34.99±27.07%、39.38 ±28.00%、43.18 ± 30.10%, there were also no significance between three groups(P>0.05). Different platelet testing ways AA-induced platelet aggregation were: (1) PL-11-AA%:34.64±22.30%、39.99±21.74%、38.55±22.32%, there were no significance between three groups(P>0.05); TEG-AA%:9.35±17.30%、18.51 ± 32.5%、19.00 ± 30.03%, there were also no significance between three groups(P>0.05). The correlation between LTA and PL-11, LTA and TEG and TEG and PL-11 in acute myocardial infarction group were 0.689,0.356,0.333, and the correlation in unstable angina group were 0.593,0.265,0.249, and the correlation in stable angina group were0.427,0.257,0.405. After follow-up for one month, the adverse events occurrence rates in three groups were 21.43%,10.45% and 2.27%, respectively. Significant differences were existed between three groups(P<0.05). Different platelet testing ways ADP-induced platelet aggregation between dverse events occurrence group and no dverse events occurrence group were:(1) LTA-ADP%:38.89±4.13%、34.26±1.62%, there were no significance between two groups(P>0.05); (2) PL-11-ADP%:41.43±2.97%、37.68±1.28%, there were no significance between two groups(P>0.05); (3)TEG-ADP%:48.69±5.55%、36.23± 2.05%, there were significance between two groups(P<0.05). Different platelet testing ways AA-induced platelet aggregation between dverse events occurrence group and no dverse events occurrence group were:(1)PL-11-AA%:46.56±4.08%、36.87± 1.65%, there were significance between two groups(P<0.05); (2) TEG-AA%:21.12± 5.72%,11.99±1.71%, there were no significance between two groups(P>0.05). MA value in TEG-mapping between two groups were:68.86±0.96mm、66.50±0.43mm, there were significance between two groups(P<0.05). MA-ADP value in TEG-mapping between two groups were:41.82±3.14mm,32.51±1.19mm, there were significance between two groups(P<0.05). MA-AA value in TEG-mapping between two groups were:27.11 ± 3.70mm、18.80± 1.02mm, here were significance between two groups(P<0.05).Conclusion:1.The stronger the resting heart rate, the higher potential activity of platelet and residual platelet activity. Clinical events with platelet and heart rate were positive correlation. We should control resting heart rate and platelet activity in clinical work, and improve prognosis.2. The correlation between LTA and PL-11 is best, which illustrated the possibility of using the PL-11 method in clinical application. Platelet aggregation and residual platelet activity are both have important monitoring value in clinical practice.