Relation Between Platelet Response to Exercise and Coronary Angiographic Findings in Patients With Effort Angina
| Autor: | Felicita Andreotti, Laura Morlacchi, Sonia Iacovella, Alfonso Sestito, Filippo Crea, Enrico Romagnoli, Attilio Maseri, Gaetano Antonio Lanza, Giovanni Schiavoni |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Physical exercise Coronary Angiography Angina Pectoris Coronary artery disease Angina Physiology (medical) Internal medicine Humans Medicine Platelet Prospective Studies Whole blood business.industry Coronary Stenosis Syndrome Venous blood Middle Aged Platelet Activation medicine.disease Confidence interval Pathophysiology Exercise Test Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 107:1378-1382 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background— Platelet reactivity is increased by exercise in patients with obstructive coronary artery disease (CAD) but not in patients with syndrome X. In this study, we prospectively investigated whether the platelet response to exercise might help distinguish, among patients with angina, those with obstructive CAD from those with normal coronary arteries (NCAs). Methods and Results— Venous blood samples were collected before and 5 minutes after exercise from 194 consecutive patients with stable angina. Platelet reactivity was measured by the platelet function analyzer (PFA)-100 system as the time for flowing whole blood to occlude a collagen-adenosine diphosphate ring (closure time). Coronary angiography showed CAD in 163 patients (84%) and NCA in 31 patients (16%). Baseline closure time was shorter in NCA patients (78.0±16 versus 95.5±23 seconds, P P P =0.0004). An increase in closure time with exercise ≥10 seconds had 100% specificity and positive predictive value for NCAs. Similarly, a decrease ≥10 seconds had 100% specificity and positive predictive value for CAD. A closure time change (increase or decrease) ≥10 seconds allowed a correct classification of 55% of all patients. Conclusions— Among patients with stable angina, the response of platelet reactivity to exercise was predictive of normal or stenosed coronary arteries at angiography. Specifically, an increase in closure time with exercise ≥10 seconds was invariably associated with the presence of NCA. |
| Databáze: | OpenAIRE |
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