運動に対する血小板応答と,労力性アンギナ患者における冠動脈血管検査の発見との関連
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
まとめ
運動は,閉塞性冠動脈疾患 (CAD) と正常な冠動脈疾患 (NCAs) の患者において,血小板の反応性に異なった影響を及ぼします. 運動後の閉塞時間の変更は,これらのグループを正確に区別することができます.
科学分野:
- 心臓病学 心臓病学
- 血液学 ヘマトロジ
- 診断医学 診断医学
背景:
- 閉塞性冠動脈疾患 (CAD) の場合,運動によって血小板の反応性が増加しますが,X症候群ではそうではありません.
- 胸痛患者において,閉塞性CADと正常な冠動脈 (NCAs) を区別することは,臨床的に重要である.
研究 の 目的:
- 運動による血小板反応の変化が,安定した心痛の患者における阻害性CADとNCAを区別できるかどうかを判断する.
主な方法:
- 冠動脈血管撮影を受ける安定したアンギナ患者194人を対象とした前向きな研究.
- 血小板機能分析器 (PFA) -100システム (閉塞時間) を使用して測定された血小板の反応性. 運動前および運動後.
- CADまたはNCAを確認するために使用される冠動脈血管撮影.
主要な成果:
- ベースラインの閉塞時間は,NCA患者 (78.0±16秒) とCAD患者 (95.5±23秒) の間で短かった.
- 運動は,CAD患者の閉塞時間を短縮した (-15.5秒),NCA患者の閉塞時間を短縮した (+12.5秒).
- 閉塞時間における≥10秒の変化は,NCAまたはCADのいずれかを患っている患者を分類するための100%の特異性を示しました.
結論:
- 運動による血小板の反応の変化は,安定した胸痛患者の冠動脈の状態を予測します.
- 運動後の閉塞時間10秒以上増加は,正常な冠動脈 (NCA) の強力な指標です.
- 運動後の閉塞時間 ≥10秒の減少は,閉塞性冠動脈疾患 (CAD) の強い指標です.
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