Relationship between post-stenting coronary thrombolysis in myocardial infarction flow and plasma von Willebrand factor and ADAMTS-13 levels in patients with ST segment elevation myocardial infarction
10.3760/cma.j.issn.0253-3758.2011.03.010
- VernacularTitle:血管性血友病因子和ADAMTS-13水平与急诊冠状动脉支架置入术后冠状动脉血流的关系
- Author:
Qing ZHOU
1
;
Jian LI
;
Xin-Ping LUO
;
Hai-Ming SHI
;
Hua CHEN
;
Bi-Lian ZHAO
;
Jun ZHU
;
Huan-Chun NI
;
Wei SHEN
;
Cai-Ping WANG
Author Information
1. 复旦大学附属华山医院
- Keywords:
Angioplasty,transluminal,percutaneous coronary;
von Willebrand factor;
Myocardial reperfusion
- From:
Chinese Journal of Cardiology
2011;39(3):212-216
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between post-stenting coronary thrombolysis in myocardial infarction (TIMI) flow and plasma von Willebrand factor (vWF) and its cleaving protease(ADAMTS-13) levels in patients with ST segment elevation myocardial infarction (STEMI). Methods STEMI patients who underwent primary percutaneous coronary intervention ( PCI ) and stenting between September, 2007 and December, 2009 were enrolled. According to the post-stenting TIMI flow, patients were divided to TIMI≤2 group (n =43) and TIMI 3 group (n =43). Patients with chest pain or dyspnea and normal coronary angiographic results served as control group ( n = 43 ). The levels of vWF and ADAMTS-13 were measured by ELISA at three time points: immediatly after admission, beginning of PCI and 1 week after PCI. Results Levels of vWF in STEMI patients at all 3 time points were significantly higher than in control patients, and the level of vWF was significantly higher in TIMI ≤2 group than in TIMI 3 group [at admission: (6721.83 ± 1380.58) U/L vs. (4786. 12 ±2362.01) U/L, P ＜0.05; at the beginning of PCI: (5744.65 ±1240. 71) U/L vs. (3011.33 ±2270.40) U/L, P＜0. 05 and at 1 week after PCI: (2001.48 ± 931.70) U/L vs. ( 1365. 17 ± 724. 12 ) U/L, P ＜ 0. 05]. ADAMTS-13 levels were similar among groups at admission and at beginning of PCI, however, the level of ADAMTS-13 at 1 week after PCI was significantly higher in TIMI≤2 group than that in TIMI 3 group [(406. 93 ± 101.44 )mg/L vs. ( 270. 34 ± 115.12) mg/L, P ＜0. 001]. Logistic regression analysis showed that both vWF at admission(OR=1.917, P＜0.01) and vWF at the beginning of PCI (OR=2.016, P＜0. 01) were risk factors of TIMI≤2. Conclusion Increased vWF during peri-PCI periods was associated with post-stenting coronary TIMI ≤2 after primary PCI in STEMI patients, and the imbalance between vWF and ADAMTS-13 may thus play an important role in the development of slow flow post PCL
