Capanni M, Prisco D, Antonucci E, Chiarugi L, Boddi V, Abbate R, Giglioli C, Dabizzi R P, Margheri M, Simonetti I, Gensini G F
Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Italy.
Int J Clin Lab Res. 1999;29(4):145-9. doi: 10.1007/s005990050081.
Percutaneous transluminal coronary angioplasty is an established therapy for coronary artery disease, but restenosis still occurs at a rate of 25%-40%. The aim of this study was to investigate the acute effect of percutaneous transluminal coronary angioplasty on platelet function and the relationship between platelet function and clinical recurrence. Spontaneous platelet aggregation was assessed before and after successful coronary angioplasty in 155 patients (120 men, 35 women). Patients were followed for a mean time of 20 months; follow-up angiography was performed only in patients with clinical recurrence. In 122 of 155 patients (79%) a significant increase in spontaneous platelet aggregation was observed immediately after coronary angioplasty. Baseline spontaneous platelet aggregation in platelet-rich plasma was significantly lower in patients with clinical recurrence than in those without (P<0.05). Kaplan-Meier event-free survival estimate showed a significant difference in clinical recurrence between patients with spontaneous platelet aggregation in platelet-rich plasma below and above the first quintile (P<0.05) with a relative risk of 2.5. In conclusion. these results indicate that percutaneous transluminal coronary angioplasty enhances spontaneous platelet aggregation and that the platelet state before coronary angioplasty affects the risk of clinical recurrence after the procedure.
经皮腔内冠状动脉成形术是治疗冠状动脉疾病的一种成熟疗法，但再狭窄仍以25%-40%的发生率出现。本研究的目的是探讨经皮腔内冠状动脉成形术对血小板功能的急性影响以及血小板功能与临床复发之间的关系。对155例患者（120例男性，35例女性）在成功进行冠状动脉成形术前和术后评估自发性血小板聚集情况。患者平均随访20个月；仅对临床复发的患者进行随访血管造影。155例患者中有122例（79%）在冠状动脉成形术后立即观察到自发性血小板聚集显著增加。临床复发患者富血小板血浆中的基线自发性血小板聚集显著低于未复发患者（P<0.05）。Kaplan-Meier无事件生存估计显示，富血小板血浆中自发性血小板聚集低于和高于第一个五分位数的患者在临床复发方面存在显著差异（P<0.05），相对风险为2.5。总之，这些结果表明经皮腔内冠状动脉成形术会增强自发性血小板聚集，且冠状动脉成形术前的血小板状态会影响术后临床复发风险。
