Serial Changes Of Platelet Function In Acute Myocardial Infarction Treated By Primary Percutaneous Transluminal Coronary Angioplasty

Objective To observe the serial change of platelet function before and early after primary percutaneous transluminal coronary angioplasty (P-PTCA)in patients with acute myocardial infarction(AMI) to provide an evidence to antiplatelet therapy for patients treated by P-PTCA. Methods 33 Patients with AMI undergoing P-PTCA successfully within 6 hours after the onset of symptom were included. Venous blood samples were obtained according to schedule. CD62P,PAC-1 and CD61b were tested by flow cytometric analysis. 10 sex and age matched healthy subjects were chosen as control group. Results 33 patients with AMI before P-PTCA, CD62P was 3.68±1.57 and PAC-1 was 1.82±0.73,they were significantly higher than control group (P<0.01); CD62P and PAC-1 decreased gradually and reached the lowest at 8 hours after PTCA,CD62p was1.85±0.71and PAC-1 was 1.35±0.66, significantly lower than that before P-PTCA; and then CD62p and PAC-1 increased gradually, reached the peak at 24hours after PTCA,CD62p was 3.98±1.52 and PAC-1 was 2.28±0.87,significantly higher than before( P<0.01); 72 hours later,CD62P and PAC-1 decreased again and reduced to the normal level 168 hours after P-PTCA. CD61b did not show significant change before P-PTCA compared with control group (P>0.05). CD61b of different time after P-PTCA did not show significant difference either (P>0.05). Conclusion P-PTCA in patients with AMI can recanalize infarction related artery(IRA)earlier but activate platelet meanwhile, the risk of acute and subacute thrombosis increased. The present data provide a basis for more effective antiplatelet strategies in AMI patients treated by P-PTCA.