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Relación entre la respuesta plaquetaria al ejercicio y los hallazgos angiográficos coronarios en pacientes con angina
Gaetano Antonio Lanza1, Alfonso Sestito, Sonia Iacovella
1Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy. g.a.lanza@inwind.it
Circulation
|March 19, 2003
Resumen
El ejercicio afecta la reactividad plaquetaria de manera diferente en pacientes con enfermedad arterial coronaria obstructiva (CAD) frente a las arterias coronarias normales (ANC). Un cambio en el tiempo de cierre después del ejercicio puede distinguir con precisión entre estos grupos.
Área de la Ciencia:
- Cardiología Cardiología.
- Hematología Hematología.
- Medicina de diagnóstico La medicina de diagnóstico es la medicina de diagnóstico.
Sus antecedentes:
- La reactividad plaquetaria aumenta con el ejercicio en la enfermedad coronaria obstructiva (CAD), pero no en el síndrome X.
- Distinguir la CAD obstructiva de las arterias coronarias normales (ANC) en pacientes con angina de pecho es clínicamente importante.
Objetivo del estudio:
- Para determinar si los cambios inducidos por el ejercicio en la reactividad plaquetaria pueden diferenciar entre CAD obstructiva y ANC en pacientes con angina estable.
Principales métodos:
- Estudio prospectivo de 194 pacientes con angina estable sometidos a angiografía coronaria.
- Reactividad plaquetaria medida con el analizador de la función plaquetaria (PFA) -100 sistema (tiempo de cierre) antes y después del ejercicio.
- La angiografía coronaria se utiliza para confirmar CAD o NCA.
Principales resultados:
- El tiempo de cierre basal fue más corto en pacientes con NCA (78.0 ± 16s) frente a pacientes con CAD (95.5 ± 23s).
- El ejercicio disminuyó el tiempo de cierre en pacientes con CAD (-15.5s) pero lo aumentó en pacientes con NCA (+12.5s).
- Un cambio de ≥10 segundos en el tiempo de cierre mostró una especificidad del 100% para clasificar a los pacientes como NCA o CAD.
Conclusiones:
- Los cambios inducidos por el ejercicio en la reactividad plaquetaria predicen el estado de la arteria coronaria en pacientes de angina estables.
- Un aumento en el tiempo de cierre ≥10 segundos después del ejercicio es un fuerte indicador de arterias coronarias normales (ANC).
- Una disminución en el tiempo de cierre ≥10 segundos después del ejercicio es un fuerte indicador de enfermedad coronaria obstructiva (CAD).
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