| Objective To investigate the platelet activation and endothelial cell disturbance in patients with acute coronary syndrome and the clinical singnificance .Methods The expression of activated glycoprotein IIb/IIIa ( GPIIb/IIIa ) on platelet and the plasma level of von Willebrand Factor ( vWF ) were analyzed with flow cytometry or ELISA between 15 normal controls and 67 patients with acute coronary syndrome induing 37 cases with acute myocardial infarction and 30 cases with unstable angina. Moreover, the correlation analysis was made between GPIIb/IIIa,vWF, troponin I (TnI) and the severity of coronary .The severity of coronary for the patients who were performed by coronary angiography were evaluated by a quantitative method. The cardiovascular events were observed in patients with acute coronary syndrome in earlier 4 weeks.Results Compared with the healty control group , platelet in patients with acute coronary syndrome was markedly activated indicated by increased expression of activated GPIIb/IIIa (P<0.0001) , the plasma level of vWF was also significantly higher(P<0.0001) . The data showed good correlations between GPIIb/IIIa, vWF and TnI (all P<0.05) . There is also appearent relation between plasma level of vWF and severity of coronarystenosis (P<0.05). 17 of 67 patients with acute coronary syndrome had early events. The incidence of eventful course was 32.4%, 16.7% respectively in acute myocardial infarction and unstable angina (P>0.05) . Patients with an event had remarkably higher vWF concentrations than those with uneventful course (P<0.0001) . GPIIb/IIIa of patients with an event were higher than uneventful subjects too (46.32±5.94 vs 42.33±9.86), but there is no statistical significance (P=0.052) .Conclusions Patients with acute coronary syndrome show evidence of platelet activation and endothelial cell disturbance. Higher plasma vWF concentrations can indicate an unexpected outcome of the patients with acute coronary syndrome .
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