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Effect of Tirofiban on MMP-9 in Patients with Angina Pectoris and Diabetes after Stent Implantatin

Author: ChenHui
Tutor: ZhaoLiHua
School: Jilin University
Course: Internal Medicine
Keywords: Angina Pectoris Diabetes Matrixmetalloproteinase-9 In-stent restenosis Tirofiban
CLC: R587.1
Type: Master's thesis
Year: 2011
Downloads: 74
Quote: 0
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Abstract

With the improvement of living standards,the life styles is changed and the rapid aging of the population into the society,such as diabetes and coronary heart disease which is more and more cardiovascular disease risk medical attention. Previous studies have found that inflammation is basic pathological mechanism in the two diseases;in recent years a large number of research that MMP-9 is an important inflammatory factors and plays an important role in atherosclerotic plaque stability,but also associated with In-stent restenosis; maybe MMP-9 is one of the pathophysiology mechanisms in plaque stability and In-stent restenosis, however, hyper glycemia can increase the inflammatory response and enhance expression of MMP-9.In recent years, domestic and international research proposed whether the early intervention treatment and use of plateletⅡb/Ⅲa receptor antagonist in patients with acute myocardial infarction and diabetes mellitus, short-term and long-term prognosis improved obviously.However,it is rare reports whether use of PlateletⅡb/Ⅲa receptor antagonists in patients with angina pectoris and diabetes mellitus after PCI.This article by looking at angina after PCI in patients with diabetes give Tirofiban continue to 24 hours after treatment, to evaluating MMP-9 levels in Tirofiban angina patients with diabetes mellitus inflammatory response.Objective:Effect of Tirofiban on MMP-9 in patients with Angina pectoris and diabetes after stent implantation, and to explore the maintenance of plaque stability Tirofiban angina patients with diabetes mellitus and restenosis after stenting.Methods:(1)They were diagnosed with diabetes and coronary heart disease patients after PCI and stenting were successful in 56 cases from 01.2010-01.2011 in the Center of Cardiovascular at First Hospital of Ji lin University.Divided into Tirofiban treatment angina pectoris group (AP+ DM+T) 18 cases; angina group (AP) 20 cases; angina and diabetes group (AP+DM) 18 cases. (2)Medication:Except for coronary heart disease and diabetes conventional drug treatment, administration of aspirin and clopidogrel 300mg before PCI.injection 3000U heparin by arterial sheath,60-100U/kg complement heparin before balloon dilation and stent; and 1 hour for each additional additional 1000u heparin. subcutaneous injection of low molecular weight heparin 5000u after PCI, twice daily.Tirofiban addition to the above treatment group before and after conventional treatment, at 30minutes after PCI Tirofiban intravenous injection, 10ug/kg 3min after the intravenous injection to 0.15ug/kg/min continued 24h.(3)collect blood samples:All selected patients were in before and after 24-hours of PCI, Plasma was immediately obtained by centrifugation of the blood at 4000 r/min for 15 minutes and then stored in several aliquots at-70℃until assayed.Plasma soluble MMP-9 levels were measured in all patients and control subjects using commercially available ELISA kits.Results:(1)Three groups general clinical situation comparison was not statistically significant.(2) three vascular lesions more than a single vascular lesions angina pectoris and diabetes groups.(3)The length of the duration of diabetes with vascular lesions were positivelycorrelated.(4) After stent placement of three groups MMP-9 concentration are more than the preoperative, P< 0.05. AP+DM+T preoperative MMP-9 levels higher than AP, AP+DM more than AP group, P< 0.05; And AP+DM+T group and AP+DM have no obvious difference.Postoperative 24hMMP-9 levels AP+DM more than AP+DM+T and AP group; and AP+DM+T and AP group MMP-9 concentration have no obvious difference.Conclusion:(1)It is common that multivessel vascular lesions in atients with angina pectoris and diabetes.(2)The longer the duration of diabetes, the heavier coronary vascular lesions.(3)hyperglycaemia levels to strengthen MMP-9 expression, aggravating vascularlesions.(4) Tiro-fiban can reduce metalloproteinases-9 level in patients with angina pectoris and diabetes after stent implantation, maybe maintain the stability helpul and lower stent restenosis rate and cardiaceents.

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