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Evaluación de la producción de tromboxano y la activación del complemento durante la isquemia miocárdica en pacientes
G Montalescot1, G Drobinski, J Maclouf
1Department of Cardiology, Hôpital Pitié-Salpétrière, Paris, France.
Circulation
|November 1, 1991
Resumen
Los pacientes con angina estable muestran un aumento de la producción de tromboxano durante la isquemia, pero no se observa la activación del sistema del complemento. Esto sugiere que el tromboxano, no el complemento, juega un papel en la isquemia miocárdica relacionada con la angina de pecho.
Área de la Ciencia:
- Cardiología Cardiología.
- La bioquímica es la bioquímica.
- Inmunología Inmunología.
Sus antecedentes:
- El sistema del complemento y los metabolitos del ácido araquidónico están implicados en la isquemia miocárdica.
- Los datos experimentales sugieren que C5a puede contribuir a la producción de tromboxano.
Objetivo del estudio:
- Investigar la producción de C5a y tromboxano durante una breve isquemia miocárdica en pacientes con angina estable.
- Para determinar el papel de la activación del complemento y la agregación plaquetaria en la liberación de tromboxano inducida por isquemia.
Principales métodos:
- Se evaluaron los niveles de C5a y tromboxano B2 en la sangre del seno coronario durante el acelerador auricular o la angioplastia coronaria transluminal percutánea.
- Medición de los metabolitos urinarios de tromboxano y prostaciclina antes y después de la prueba de ejercicio.
- Monitoreó los cambios en el segmento ST y la extracción de lactato para evaluar la gravedad de la isquemia.
Principales resultados:
- La isquemia inducida por el ritmo cardíaco aumentó los niveles de tromboxano B2 en el seno coronario, correlacionándose con los cambios en la extracción de lactato.
- No se detectó un aumento significativo en C5a, C3a o C5b-9 durante la isquemia.
- Los pacientes con angina de pecho estable exhibieron niveles más altos de metabolitos de tromboxano urinario al inicio, lo que indica un aumento crónico de la síntesis.
Conclusiones:
- El tromboxano se libera de forma aguda durante la isquemia miocárdica inducida por el ritmo cardíaco en la angina estable, independientemente de la agregación plaquetaria significativa.
- La activación del sistema de complemento no parece estar involucrada en los episodios isquémicos breves en la angina estable.
- La elevación crónica de la síntesis de tromboxano está presente en pacientes con angina estable.
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