Objective To investigate the effects of tongxinluo pretreatment on platelet activity and function of vascular endothelium and TIMI blood flow as well as prognosis in patients with acute myocardial infarction after delayed PCI.
Methods 80 patients with acute coronary syndrome were randomly divided into tongxinluo (TXL) pretreatment group (40 patients) and conventional treatment group (40 patients). 40 healthy people as control group. we examined the patient's blood CD62p, CD63, glucose protein (GP)IIb/IIIa and endothelium 1(ET-1), von Willebrand factor (vWF), nitric oxide (NO) levels from before treatment and one week and one month after the treatment of PCI in the two groups. Then the patients in TXL group received TXL treatment for 1 week (4 tablet tid) before PCI and compared the above parameters, TIMI bood flow, corrective TIMI flow count (CTFC)with conventional treatment group.
Results The AMI patient' s blood CD62p, CD63, GPIIb/IIIa, vWF and ET-1 levels increased significantly (all p < 0.01), NO decreased significantly (p < 0.01), the AMI patient' s plasma levels of vWF increased significantly (p < 0.05) compared with healthy control group. In both TXL treatment group and convention treatment group, the patient's plasma levels of CD62p, CD63, GPIIb/IIIa, vWF and ET-1 decreased significantly (p < 0.05, p < 0.01) compared with pre-treatment group, while there were different significantly of all parameters above between TXL group and conventional treatment group after treatment of one week (p < 0.01, p < 0.05), In addition, the parameter above showed significantly different after treatment of one month than one week (p < 0.01, p < 0.05). The TIMI blood flow in TXL group was obviously better than the convention treatment group. The left ventricular ejective factor (LVEF) in TXL group obviously increased than convention treatment group. There were 1 cases of sudden death, 6 cases of recurrent angina, 6 case of heart failure, 3 cases of ventricular tachycardiac (VT)/ventricular fibrillation (VF) in conventional treatment group, while there were 2 case of recurrent angina, 2 case of heart failure, 2 cases of VT/ VF and without sudden death occurred in the TXL treatment group after one months. Conclusion
TXL can inhibit the patient's platelet activity and protect the vascular endothelium function as well as improve the TIMI blood flow and cardial function as well as the prognosis after the treatment of PCI.
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