Department of Cardiology, the Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
J Zhejiang Univ Sci B. 2010 Aug;11(8):575-82. doi: 10.1631/jzus.B1001006.
This study aims to determine the mechanisms underlying restenosis and ischemia-reperfusion injury of the myocardium after percutaneous coronary intervention (PCI).
The present study examined serial changes (5 min, 30 min, 2 h, 6 h, and 24 h after PCI) in circulating P-selectin, plasminogen activator inhibitor-1 (PAI-1), magnesium (Mg), and creatine kinase-myocardial band fraction (CK-MB) levels, which may be associated with restenosis and myocardial injury in patients undergoing PCI. The occurrence rates of major adverse cardiovascular events were collected over a six-month follow-up.
PCI induced an early elevation of P-selectin, which correlated positively with the inflation pressure used in the PCI procedure. PCI also caused a significant and sustained decrease in serum Mg in PCI patients, without an effect on PAI-1. An increase in CK-MB was observed in PCI patients, although values were within normal reference range. In addition, elevated P-selectin and decreased Mg measured shortly after the coronary angioplasty procedure were associated with recurrent treatment and heart failure, respectively.
Our study demonstrates that PCI induces temporal changes of P-selectin, Mg, and CK-MB, which may be involved in restenosis and ischemia-reperfusion injury. These findings highlight the need for using antiplatelet therapy and Mg to reduce the risks associated with PCI.
本研究旨在确定经皮冠状动脉介入治疗(PCI)后再狭窄和心肌缺血再灌注损伤的机制。
本研究检测了循环 P-选择素、纤溶酶原激活物抑制剂-1(PAI-1)、镁(Mg)和肌酸激酶心肌带分数(CK-MB)水平在 PCI 后 5 分钟、30 分钟、2 小时、6 小时和 24 小时的连续变化,这些变化可能与接受 PCI 的患者的再狭窄和心肌损伤有关。在六个月的随访期间收集了主要不良心血管事件的发生率。
PCI 诱导了 P-选择素的早期升高,与 PCI 过程中使用的膨胀压力呈正相关。PCI 还导致 PCI 患者血清 Mg 显著且持续下降,对 PAI-1 没有影响。在 PCI 患者中观察到 CK-MB 的增加,尽管值在正常参考范围内。此外,冠状动脉成形术后不久测量的升高的 P-选择素和降低的 Mg 分别与复发性治疗和心力衰竭有关。
我们的研究表明,PCI 诱导了 P-选择素、Mg 和 CK-MB 的时间变化,这些变化可能与再狭窄和缺血再灌注损伤有关。这些发现强调了使用抗血小板治疗和 Mg 来降低与 PCI 相关风险的必要性。