Manolis A S, Melita-Manolis H, Stefanadis C, Toutouzas P
Department of Microbiology, Hippokration Hospital, Athens University Medical School, Greece.
Clin Cardiol. 1993 Jul;16(7):548-52. doi: 10.1002/clc.4960160707.
Fibrinopeptide A (FPA) is a small polypeptide cleaved from fibrinogen by thrombin, has a short half-life, and is considered a sensitive biochemical marker of thrombin activity, fibrin generation, and ongoing thrombosis. Increased plasma levels of FPA have been reported in various procoagulable and thrombotic medical and cardiovascular disorders, including acute myocardial infarction, unstable angina, and sudden cardiac death. However, activation of thrombosis by the arterial injury incurred during coronary angioplasty has not been systematically examined with use of plasma FPA measurements. To detect and monitor activation of thrombosis by coronary angioplasty, plasma levels of FPA were obtained by venipuncture and measured by radioimmunoassay before, immediately after, 24 to 48 h later, and 1 and 3 months after uncomplicated coronary angioplasty. From December 1990 through June 1991, FPA was measured in 30 patients (28 men and 2 women, aged 54 +/- 9 years) with coronary artery disease who were undergoing coronary angioplasty. The mean left ventricular ejection fraction was 55 +/- 7%. The dilated vessel was the left anterior descending coronary artery in 20 patients (together with a second vessel in 2), the right coronary artery in 9, and the left circumflex in 1. The procedure was successful and free of major complications in all patients. Before angioplasty the FPA levels averaged 6.50 +/- 1.18 ng/ml. Shortly after angioplasty they rose to 20.20 +/- 7.91 ng/ml (p = 0.08) despite intravenous heparin. At 24 to 48 h and after heparin had been discontinued for at least 4 h, the mean FPA levels were significantly higher (32.33 +/- 10.86 ng/ml) compared with baseline values (p = 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
纤维蛋白肽A（FPA）是一种由凝血酶从纤维蛋白原上裂解下来的小多肽，半衰期短，被认为是凝血酶活性、纤维蛋白生成及正在发生的血栓形成的敏感生化标志物。据报道，在各种促凝和血栓形成的医学及心血管疾病中，包括急性心肌梗死、不稳定型心绞痛和心源性猝死，血浆FPA水平会升高。然而，冠状动脉成形术期间动脉损伤引发的血栓形成激活情况尚未通过血浆FPA测量进行系统研究。为了检测和监测冠状动脉成形术引发的血栓形成激活情况，在无并发症的冠状动脉成形术前、术后即刻、术后24至48小时以及术后1个月和3个月，通过静脉穿刺获取血浆并采用放射免疫分析法测量FPA水平。从1990年12月至1991年6月，对30例（28例男性和2例女性，年龄54±9岁）接受冠状动脉成形术的冠心病患者进行了FPA测量。平均左心室射血分数为55±7%。20例患者扩张的血管为左前降支冠状动脉（其中2例还涉及另一支血管），9例为右冠状动脉，1例为左旋支冠状动脉。所有患者手术均成功且无重大并发症。冠状动脉成形术前FPA水平平均为6.50±1.18 ng/ml。尽管使用了静脉肝素，术后不久FPA水平升至20.20±7.91 ng/ml（p = 0.08）。在24至48小时且肝素停用至少4小时后，平均FPA水平与基线值相比显著升高（32.33±10.86 ng/ml）（p = 0.025）。（摘要截断于250字）
