Yasar Ayse Saatci, Erbay Ali Riza, Ayaz Selime, Turhan Hasan, Metin Fatma, Ilkay Erdogan, Sabah Irfan
Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
Coron Artery Dis. 2007 Sep;18(6):451-4. doi: 10.1097/MCA.0b013e3282a30665.
The common coexistence with coronary artery disease has led to the suggestion that coronary artery ectasia (CAE) is a variant of coronary artery disease. The mechanisms, however, responsible for CAE formation during the atherosclerotic process and the exact clinical significance are not well known. In this study, we aimed to investigate platelet activity in patients with isolated CAE by using specific markers of platelet activation as P-selectin, beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4).
Thirty-two patients with isolated CAE without significant stenosis and 30 control participants with angiographically normal coronary arteries were included in this study. According to the angiographic definition used in the Coronary Artery Surgery Study, a vessel is considered to be ectasic when its diameter is > or = 1.5 times that of the adjacent normal segment in segmental ectasia. Plasma P-selectin, beta-TG and PF4 levels were measured in all patients and control participants using enzyme-linked immunosorbent assay method.
Patients with isolated CAE were detected to have significantly higher levels of plasma P-selectin, beta-TG and PF4 in comparison with control participants with angiographically normal coronary arteries (P-selectin: 248+/-46 vs. 154+/-32 ng/ml, respectively, P<0.001; beta-TG: 51+/-19 vs. 21+/-9 ng/ml, respectively, P<0.001; PF4: 58+/-23 vs. 33+/-11 ng/ml, respectively, P<0.001).
In conclusion, we have shown for the first time that patients with isolated CAE have raised levels of plasma P-selectin, beta-TG and PF4 compared with control participants with angiographically normal coronary arteries, suggesting increased platelet activation in patients with CAE.
冠状动脉扩张（CAE）常与冠状动脉疾病并存，这使得有人提出CAE是冠状动脉疾病的一种变体。然而，在动脉粥样硬化过程中导致CAE形成的机制以及确切的临床意义尚不清楚。在本研究中，我们旨在通过使用血小板活化的特异性标志物，如P-选择素、β-血小板球蛋白（β-TG）和血小板因子4（PF4），来研究孤立性CAE患者的血小板活性。
本研究纳入了32例无明显狭窄的孤立性CAE患者和30例冠状动脉造影正常的对照参与者。根据冠状动脉外科研究中使用的血管造影定义，当节段性扩张时血管直径≥相邻正常节段直径的1.5倍，则认为该血管为扩张性血管。使用酶联免疫吸附测定法测量所有患者和对照参与者的血浆P-选择素、β-TG和PF4水平。
与冠状动脉造影正常的对照参与者相比，孤立性CAE患者的血浆P-选择素、β-TG和PF4水平显著更高（P-选择素：分别为248±46与154±32 ng/ml，P<0.001；β-TG：分别为51±19与21±9 ng/ml，P<0.001；PF4：分别为58±23与33±11 ng/ml，P<0.001）。
总之，我们首次表明，与冠状动脉造影正常的对照参与者相比，孤立性CAE患者的血浆P-选择素、β-TG和PF4水平升高，提示CAE患者血小板活化增加。
