Change And Predictor Early Complication Of ET VWF CD₄₁ Around PCI

Object: Percutaneous Coronary intervention(PCI) ha\'e been a main established myocardial revasculariza-tion procedure, Because its success rate is 90% at frist treatment PCI is rapidly practised in all over the world: however, the risk of acute complications ranges from 5皁 to 30% in unstable patients. Preprocedural identification of risk patients who might benefit from additional procedures, would be desirable: In the past, weak correlations with early complications following PCI were reported such as female gender, extreme age, diabetes, multivessel disease, lesion characteristics. In recent clinical practice and laboratory investigation, there are distinct difference of endothelial dysfunction and platelet activation among unstable angina, acute myocardial infarction, stable angina, moreover, PCI can induce change of cell factors such as Endothelin (ET) Von Willebrand factor (vWF), platelet membrane glycoprote-ins IIb/EIa(CD41).The aim of this study is to investigate the change and predictor early complications of these factors aroundPCI.Methods: The study population consist of 78 patients who undenwent Percutaneous transluminal coronary angioplasty (PTCA)and stent on a single nonocclusive coronary stenosis;40 had unstable angina and 38 had stable angina.Exclusion criteria were: total occlusion, left Ventricular ejection fraction <30%, left bundle branch block, valvular heart disease, acute phase operationsor wound, renal or liver dysfunction, acute inflammation, acute Leukemia, cirrhosis of liver, high pressure of lung artery, bronchial asthma, von willebrand disease.The general types of twenty normal coronary artery by coronary angiogram are also the same as the PCI patients.All patients recorded ager sex. systemic hypertension, diabetes mellitu, total cholesterin, triglycerides, cigarette smoking, myocardial infarction.Blood sampling: Peripheral blood samples for measurement of EF, vWF CD41 were taken immediately before PCI, immediately after PCI, 30min, 4h , 12h, 24h, 48h , 72h ,7 days after PCI respectively. During 2h platelet activation marker analysis carry out with single platelet flow cytometry. coded plasma samples were stored at -80 "C and analyzed in two batch at the study.Laboratory- assays: EF and vWF was analyzed with Enzyme Immunometric Assay. CD41 was analyzed with single platelet flow cytometry.Early cmplications: abrupt occlusion, defined as an acute flow reduction (TIMI 0-1); threatened abrupt occlusion, defined as lummal dissection or new thrombus appearance with delayed runoff of contrast or TIMI grade 2 flow; or early recurrence of ischemia, defined as rest angina associated with transient ECG signs of myocardial ischemia or MI before hospital discharge; sudden cardiac death;repeat coronary revascularization PTCA or CAJBG, was also evaluated.The statistical analysis was performed by using the Statistical Package for Social Sciences software(SPSS10. 0).p value<0.05 was considered statistically significant.Results: Incidnce of the early complications is 12.8% in the whole population,Incidnce of UAP is higher than that of SAP(table 3, p<0.05); The levers of ET, vWF\ CD41 of patients of early complications before PCI is higher than those no early complications before PCI( table 4,p<0.05);the increase of ET vWF CD41, of patients of early complications after PCI is higher than no early complications after PCI (table 5, Fig l,p<0.05); the higher of ET, vWF, CD41, before PCI the higher incidence of early complication after PCI. ET vWFhypertension, diabetes before PCI are independent predic -tors of early complications (Table 5,RR=2.148 ,RR=2.849 RR=1.742,RR=1.587) The increase of CD41and vWF after PCI is Positive correlation, vWF, ET is also positive correlation (Fig 2, Fig 3).Conclusions: Our study shows that the unstable angina patients have more early complications, there were endothelial dysfunction and platelets activation in the coronary artery circulation: the higher before ET vWF CD41 before PCI, the higher incidence of early comp...