Acute and long-term effect of percutaneous coronary intervention on serially-measured oxidative, inflammatory, and coagulation biomarkers in patients with stable angina.
Acute and long-term effect of percutaneous coronary intervention on serially-measured oxidative, inflammatory, and coagulation biomarkers in patients with stable angina.
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DOI：
10.1007/s11239-016-1351-6
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发表时间：
2016-05
影响因子：
4
通讯作者：
Tsimikas S
中科院分区：
文献类型：
--
作者：
Leibundgut G;Lee JH;Strauss BH;Segev A;Tsimikas S
目的：了解稳定性心绞痛患者接受经皮冠状动脉介入治疗(PCI)后氧化、炎症和凝血生物标志物的时间变化。经皮冠状动脉介入治疗与血管壁的各种生化和机械应力有关。氧化磷脂存在于纤溶酶原(OxPL-PLG)上，并在体外增强纤溶作用。我们最近发现急性心肌梗死后OxPL-PLG升高，提示它们参与动脉粥样硬化血栓形成。对125例稳定型心绞痛患者行无并发症的经皮冠状动脉介入治疗，分别于术前、术后即刻、术后6小时、24小时、3天、7天、1、3、6个月采集血浆标本。用已建立的方法测定纤溶酶原水平、OxPL-PLG和16种氧化、炎症和凝血生物标志物。术后即刻OXPL-PLG和纤溶酶原显著下降，回升至基线水平，3天达到峰值，6个月后缓慢恢复至基线水平(P<；0.0001)。术后第1天：炎症标志物IL-6和CRP；第3天-凝血标志物OxPL-PLG、纤溶酶原和组织纤溶酶原活性；第3-7天-纤溶酶原激活物抑制物；第7-30天-补体因子H与丙二醛-低密度脂蛋白结合、PAI-1活性、丙二醛-低密度脂蛋白和IgM、CuOxLDL-IgM和载脂蛋白B-IC-IgM和免疫球蛋白。大多数生物标志物在6个月后趋于基线。经皮冠状动脉介入治疗会导致特定的、时间序列的血浆生物标记物的变化。这些观察结果提供了对在经皮冠状动脉介入治疗中医源性气压创伤和斑块破裂的影响的洞察力，并提出了解释经皮冠状动脉介入治疗并发症的研究途径和开发靶向治疗以提高手术成功率的建议。
To derive insights into the temporal changes in oxidative, inflammatory and coagulation biomarkers in patients with stable angina undergoing percutaneous coronary intervention (PCI). PCI is associated with a variety of biochemical and mechanical stresses to the vessel wall. Oxidized phospholipids are present on plasminogen (OxPL-PLG) and potentiate fibrinolysis in vitro. We recently showed that OxPL-PLG increase following acute myocardial infarction, suggesting that they are involved in atherothrombosis. Plasma samples were collected before, immediately after, 6 and 24 hours, 3 and 7 days, and 1, 3, and 6 months after PCI in 125 patients with stable angina undergoing uncomplicated PCI. Plasminogen levels, OxPL-PLG, and array of 16 oxidative, inflammatory and coagulation biomarkers were measured with established assays. OxPL-PLG and plasminogen declined significantly immediately post-PCI, rebounded to baseline, peaked at 3 days and slowly returned to baseline by 6 months (p<0.0001 by ANOVA). The temporal trends to maximal peak in biomarkers were as follows: immediately post PCI: OxPL-apoB and lipoprotein (a); Day 1- the inflammatory biomarkers IL-6 and CRP; Day 3- coagulation biomarkers OxPL-PLG, plasminogen and tissue plasminogen activity; Day 3-7- plasminogen activator inhibitor; and Day 7-30- complement factor H binding to malondialdehyde-LDL, PAI-1 activity, MDA-LDL IgG and IgM, CuOxLDL IgM, and ApoB-IC IgM and IgG. Most of the biomarkers trended to baseline by 6 months. PCI results in a specific, temporal sequence of changes in plasma biomarkers. These observations provide insights into the effects of iatrogenic barotrauma and plaque disruption during PCI and suggest avenues of investigation to explain complications of PCI and development of targeted therapies to enhance procedural success.