Thrombin generation in human coronary arteries after percutaneous transluminal balloon angioplasty.
Thrombin generation in human coronary arteries after percutaneous transluminal balloon angioplasty.
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经皮腔内球囊血管成形术后人冠状动脉中凝血酶的产生。
DOI：
10.1016/0735-1097(94)90144-9
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发表时间：
1994
影响因子：
24
通讯作者：
Ambrose,JA
中科院分区：
文献类型：
--
作者：
Marmur,JD;Merlini,PA;Sharma,SK;Khaghan,N;Torre,SR;Israel,DH;Ardissino,D;Ambrose,JA
目标.本研究的目的是探讨冠状动脉粥样硬化斑块损伤与凝血级联激活的关系。动脉粥样硬化斑块破裂后血栓形成与动脉粥样硬化、不稳定型心绞痛和心肌梗死的发病机制有关。在经皮冠状动脉腔内成形术前、术中和术后即刻测定冠状动脉血中凝血酶生成（凝血酶原片段F1+2）和凝血酶活性（纤维蛋白肽A）的生化标志物。在证明通过血管成形术导管抽血不会人为升高肝素化后患者血浆中这些标志物的水平后，在26例患者中收集了球囊扩张前病变近端和远端以及球囊扩张后病变远端的冠状动脉样本。血管成形术前在病变近端测量的血浆F1+ 2水平（中位数0.47 nmol/L，95%置信区间[CI] 0.40 - 0.50）在血管成形术后显著升高（中位数0.55 nmol/L，95% CI 0.46 - 0.72，p = 0.001）。相比之下，血管成形术前病变近端测量的血浆纤维蛋白肽A水平（中位数2.0 ng/ml，95% CI 1.3 - 22）与血管成形术后测量的水平相似（中位数1.8 ng/ml，95% CI 1.3 - 3.0，p = NS）。在我们根据血管成形术前从病变近端和远端抽取的样本值定义了测定间变异性的正常范围后，7例患者（27%）的F1+ 2血浆水平显著升高。这7例患者中有5例血浆纤维蛋白肽A显著升高。血管成形术后血管造影显示有夹层、充盈缺损或模糊的病变比无这些特征的病变产生更多凝血酶。通过血管成形术导管抽取的肝素化血液可以安全地收集血栓生成和活动的标志物，并准确地进行分析。在接受血管成形术的大量患者亚组中，冠状动脉狭窄的球囊扩张增加了冠状动脉内凝血酶的生成和活性。
Objectives. The aim of this study was to investigate the relation between coronary atherosclerotic plaque injury and activation of the coagulation cascade.Background. Thrombus formation after atherosclerotic plaque disruption has been implicated in the pathogenesis of atherosclerosis, unstable angina and myocardial infarction.Methods. Biochemical markers of thrombin generation (prothrombin fragment F1+2) and thrombin activity (fibrinopeptide A) were measured in coronary blood before, during and immediately after percutaneous transluminal coronary angioplasty. After demonstrating that blood withdrawal through an angioplasty catheter does not artifactually elevate the plasma levels of these markers in patients after heparinization, coronary artery samples ware collected proximal and distal to the lesion before and distal to the lesion after baltoon inflation in 26 patients.Results. Plasma levels of F1+2measured proximal to the lesion before angioplasty (median 0.47 nmol/liter, 95% confidence interval [CI] 0.40 to 0.50) were significantly elevated after angioplasty (median 0.55 nmol/liter, 95% CI 0.46 to 0.72, p = 0.001). In contrast, plasma fibrinopeptide A levels measured proximal to the lesion before angioplasty (median 2.0 ng/ml, 95% CI 1.3 to 22) were similar to those measured after angioplasty (median 1.8 ng/ml, 95% CI 1.3 to 3.0, p = NS). After we defined a normal range of interassay variability on the basis of values obtained from samples drawn proximal and distal to the lesion before angioplasty, seven patients (27%) had a significant increase in F1+2plasma levels. A significant increase in plasma fibrinopeptide A occurred in five of these seven patients. Lesions with dissection, filling defects or haziness on postangioplasty angiography were associated with more thrombin generation than lesions without these features.Conclusions. Markers of thrombio generation and activity can be collected safely and assayed accurately in heparinized blood withdrawn through aa angioplasty catheter. Balloon dilation of coronary stenoses increases thrombin generation and activity within the coronary artery in a substantial subgroup of patients undergoing angioplasty.
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DOI：
--
发表时间：
1962
期刊：
Journal of Physiology
影响因子：
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DOI：
10.1152/jappl.1986.61.2.791
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Journal of applied physiology (Bethesda, Md. : 1985)
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DOI：
--
发表时间：
1982
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Journal of Physiology
影响因子：
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H. Loeschcke
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BENITA, M;CONDE, H
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DOI：
--
发表时间：
1979
期刊：
Journal of Physiology
影响因子：
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作者：
N. Cherniack;C. von Euler;I. Homma;F. Kao
通讯作者：
F. Kao