| Object: Coronary heart disease(CHD)has been the first fatal disease threatening people's lives in the world. Doctor Gruentzig successfully applied the technique of percutaneous transluminal coronary angioplasty (PTCA) in the clinical treatment at first in september of 1977, which meaned that coronary heart disease entered a new period of interventional treatment. With the rapid development of interventional cardiology, PTCA has been one of the main measures for coronary heart disease in the past twenty years. But restenosis after PTCA lowers its long-term effect . Stent implantation may reduce incidence of restenosis, however, stenting can not make restenosis disappear. In recent years clinical and experimental studies have confirmed that exaggerated neointimal thickening and smooth muscle cell transfer caused by stenting are the main reason of restenosis after percutaneous coronary intervention(PCI), of which the vascular injury caused by intervention process , sequent activation and aggregation of platelet and release of growth factors play an important role in restenosis after stenting. In this study the prognostic value of von Willebrand factor (vWF),glucoprotein IIb/IIIa(GPIIb/IIIa,CD41),vascularendothelial growth factor(VEGF) for restenosis, the dynamic changes of vWF,CD41,VEGF were examined in 98 consecutive coronary heart disease patients who underwent PCI.Methods: The study group comprised 98 consecutive patients who underwent both coronary angioplasty and stenting on a single coronary stenosis. 52 patients had unstable angina pectoris, 46 patients had stable angina pectoris, At the same time 40 angiographically normal patients as controls.Exclusion criteria were: total occlusion, left ventricular ejection fraction <30%, left bundle branch block, valvular heart disease, recent operation and trauma, renal or liver dysfunction, acute inflammation, acute leukemia, acute cerebrovascular disease, cirrhosis of liver, pulmonary hypertension, bronchial asthma, von Willebrand disease. Age,gender, hypertension ,diabetes,myocardial infarction cholesterol ,HDL ,LDL and smoking were recoded in every patients in detail. Oral drugs such as nitroglycein ,ACEI and β receptor antagonist were used in patients. 300mg aspirin and 500mg ticlopidine were given for three days before PCI routinly.Blood sampling: Peripheral blood samples were taken at the time of before and 30 min ,4h,12h,24h,48h,72h,7d after PCI, follow-up period respectively. CD41 was measured by flow cytometry , Coded samples were stored at-80℃ and analyzed in a single batch at the end of the study, thus, patient management was independent of these results. Blood samples of 40 angiographically normal patients were got before and 30 min ,4h,12h,24h,48h,72h,7d after procedure.Laboratory assays: vWF and VEGF were assayed by an automated monoclonal antibody solid phase sandwich-type enzyme immunosorbent assay . CD41 was measured by flow cytometry with Cell Quest software within 2 hours.After the procedure, all patients had creatine kinase measurements every 24h for 3 days and daily recording of electrocardiogram(ECG) for a week. Low molecules heparin was injected subcutaneously for 3 days. 150mg aspirin were given for a week and 500mg ticlopidine for a month after PCI routinly. CAG was performed again at 6-8 months after PCI or having evidents of re-myocardial ischemia, the rate of CAG was 75.5%(74/98). Definition of restenosis: Either of following two events within 3-12 months: Recurrence of myocardial ischemia in interventional related artery or re-angina with reversible ST segment elevating or depressing ≥1mm in at least two contiguous leads on the electrocardiogram; Loss of intraluminal diameter was more than 50% of the acute gain. The statistical analysis was performed using the Statistical Package for Social Sciences software (SPSS 10.0 for Windows, SPSS Inc, Illinois). Logistic Regression Analysiswas used to predict the main factors and also Hosmer-Lemeshow goodness...
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