Ercan Ertugrul, Bozdemir Huseyin, Tengiz Istemihan, Sekuri Cevad, Aliyev Emil, Akilli Azem, Akin Mustafa
Cardiology Department, Central Hospital, 1644 Sk No:2/2 35010 Bayrakli/Izmir, Turkey.
Thromb J. 2004 Apr 1;2(1):4. doi: 10.1186/1477-9560-2-4.
The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1) in patients with unstable angina pectoris (AP). METHODS: Thirty-five patients with unstable AP (Group I), ten patients with stable AP (Group II) and ten subjects who had angiographycally normal coronary arteries (Group III) were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15) received tirofiban and Group IB (n = 20) did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h) in all patients and at 72 h in Group I. RESULTS: The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. CONCLUSION: The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point.
由中性粒细胞和单核细胞黏附于内皮细胞引发的炎症反应在急性冠脉综合征的发病机制中起重要作用。血小板通过与单核细胞和中性粒细胞相互作用在炎症过程中发挥重要作用。在本研究中，我们调查了替罗非班对不稳定型心绞痛（AP）患者细胞黏附分子（可溶性细胞间黏附分子-1，sICAM-1，和血管细胞黏附分子-1，sVCAM-1）水平的影响。方法：35例不稳定型AP患者（I组）、10例稳定型AP患者（II组）和10例冠状动脉造影正常的受试者（III组）纳入研究。I组根据具体治疗方案分为两个亚组：IA组（n = 15）接受替罗非班治疗，IB组（n = 20）未接受。所有患者在零时（基线；0小时）采集用于检测细胞黏附分子的血样，I组在72小时时再次采集。结果：I组sICAM-1和sVCAM-1的基线水平高于II组和III组。IA组高于IB组。然而，IA组在输注替罗非班后sICAM-1和sVCAM-1水平显著降低。相比之下，IB组在72小时时这些水平保持不变或高于基线值。结论：不稳定型AP患者在输注替罗非班后细胞黏附分子水平显著降低。特异性糖蛋白IIb/IIIa拮抗剂抑制血小板功能可能会减少血小板介导的炎症反应和缺血终点事件。
