INHIBITION OF PLATELET ACTIVITY BY S-NITROSOGLUTATHIONE DURING CORONARY ANGIOPLASTY
INHIBITION OF PLATELET ACTIVITY BY S-NITROSOGLUTATHIONE DURING CORONARY ANGIOPLASTY
复制标题
DOI：
10.1016/s0140-6736(94)90287-9
复制
发表时间：
1994-11-26
期刊：
影响因子：
168.9
通讯作者：
MONCADA, S
中科院分区：
文献类型：
--
作者：
LANGFORD, EJ;BROWN, AS;MONCADA, S
血小板活化与经皮冠状动脉腔内成形术(PTCA)后的急性血管闭塞和慢性再狭窄有关，有机硝酸盐通过释放血管扩张剂和抗血小板制剂一氧化氮(NO)来发挥作用，主要是血管扩张作用，并在抑制血小板激活所需的剂量下导致低血压。S-亚硝基谷胱甘肽(GSNO)是一种对血小板具有优先作用的NO供体。从冠状静脉窦采血，检测血小板表面P-选择素和糖蛋白IIb/IIIa的表达，以此作为血小板活化的指标。在7名对照组患者中，PTCA导致血小板表面P-选择素和糖蛋白IIb/IIIa的表达增加，在PTCA后5分钟达到最大值，表明尽管接受了阿司匹林、硝酸甘油和肝素的治疗，但血小板活化仍增加。6例患者于PTCA术前10min开始冠脉内注入GSNO。GSNO能显著抑制PTCA诱导的血小板表面P-选择素和糖蛋白IIb/IIIa的表达，但不改变血压。这些结果表明，PTCA后血小板被激活，GSNO可以阻止这种激活。
Platelet activation is associated with acute vessel occlusion and chronic restenosis after percutaneous transluminal coronary angioplasty (PTCA), Organic nitrates, which act by releasing the vasodilator and anti-platelet agent nitric oxide (NO), have a predominantly vasodilator action and cause hypotension at doses required to inhibit platelet activation. S-nitrosoglutathione (GSNO) is an NO donor with a preferential action on platelets.We investigated platelet activation in patients undergoing PTCA and the effect of GSNO. Blood was sampled from the coronary sinus to measure platelet surface expression of P-selectin and glycoprotein IIb/IIIa as indices of platelet activation. In 7 control patients, PTCA caused a rise in platelet surface expression of P-selectin and glycoprotein IIb/IIIa, which was maximal 5 minutes after PTCA, indicating increased platelet activation despite treatment with aspirin, glyceryl trinitrate, and heparin. 6 patients received an intracoronary infusion of GSNO, starting 10 min before PTCA. GSNO significantly inhibited the PTCA-induced increase in platelet surface expression of P-selectin and glycoprotein IIb/IIIa without altering blood pressure.These findings show that platelets are activated following PTCA and that GSNO can prevent this activation.