Effect of Sirolimus-eluting stents implantation on platelet activation under dual anti-platelet therapy / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate the changes in platele aciveation in terms of platelet fibrinogen receptor expression(PAC-1),P-selectin(CD62P),Thromboxane B2(TXB2),Endothlin(ET-1),Fibrinogen(FIB)in patients undergoing elective Sirolimus-eluting stents implantation and dual anti-platelet therapy.Methods Forty in-hospital patients with stable coronary heart disease(CHD)were enrolled in this study.Dural anti-platelet therapy with aspirin and clopidogrel were prescribed at least three days before operation to achieve sufficient inhibition of platelet activation in all patients.Peripheral artery blood samples were collected before the procedures,immediately and at 6 hours and 24 hours after the procedure,levels of PAC-1,CD62P,TXB2,ET-1 and FIB were measured.All patients were followed up for 6-12 months.Results Expression of PAC-1 and CD62P was increased significantly after stenting compared with pre-stenting and the peak appeared at 6 hours post-operation(PAC-1,P=0.001,CD62P,P=0.007,PAC1+CD62P,P=0.003).TXB2 was also increased and the peak appeared at 24 hours post operation(P=0.021).Plasma levels of ET-1 and FIB showed no difference before and after stenting.After CAG,expression of PAC-1 and CD62P,levels of TXB2,ET-1 and FIB had no significant differences compared with pre-CAG.No MACE happened in all patients.Conclusion The routine dual anti-platelet therapy cannot suppress platelet activation after elective coronary Sirolimus-eluting stents implantation.Plasma FIB and ET-1 levels were not affected by stents implantation.