RESUMEN
The study investigated the clinical usefulness of a new method to evaluate platelet activation and the variability of platelet response to anti-platelet therapy in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Platelet activation was assessed in parallel by a new method for platelet density measurements (MPC, Mean Platelet Component Concentration), on the automated ADVIA 120 Hematology System and by the classic measurement of P-selectin (CD62P) expression, on a fluorescence flow cytometer. Patients received a loading dose of clopidogrel (300 mg; n = 29) or a bolus of abciximab (0.25 mg/kg; n = 15). Blood samples were collected before (baseline) and at different times after PTCA and antiplatelet drugs administration. Our data showed a close inverse correlation between the change in MPC and the CD62P fluorescence surface marker expression (r = -0.776, P<0.0001). Individual platelet activation determinations in patients receiving either clopidogrel or abciximab showed a variation in platelet activation as assayed by MPC and CD62P expression. Patients were characterized as having either high platelet activity upon admission and positive response to treatment or no detectable platelet activation before or after treatment. This study demonstrates the heterogeneity of platelet activation states in ACS patients undergoing coronary angioplasty. The present work also illustrates the potential use of the MPC parameter, generated on an automated hematology system, to define high risk patients and to monitor the variability of platelet response to anti-platelet therapies.
Asunto(s)
Angioplastia/métodos , Plaquetas/efectos de los fármacos , Recuento de Células/métodos , Citometría de Flujo/métodos , Cardiopatías/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Ticlopidina/análogos & derivados , Abciximab , Anciano , Anticuerpos Monoclonales/farmacología , Plaquetas/metabolismo , Clopidogrel , Ácido Edético/química , Femenino , Colorantes Fluorescentes/farmacología , Humanos , Fragmentos Fab de Inmunoglobulinas/farmacología , Masculino , Persona de Mediana Edad , Selectina-P/biosíntesis , Activación Plaquetaria/efectos de los fármacos , Riesgo , Ticlopidina/farmacología , Factores de TiempoRESUMEN
AIM: To assess the feasibility of implementing a 14-week aerobic interval training (AIT) program within a first-episode psychosis (FEP) service and its efficacy in improving metabolic outcomes and cardiorespiratory fitness. METHOD: Twenty-five male subjects participated in 30-minute sessions of AIT twice a week. RESULTS: Sixteen of 25 subjects completed the training program. There was a significant decrease in waist circumference (WC; -4.3 cm; p=0.015), resting heart rate (-8.6 bpm; p<0.05) and a 38% increase in VO2max (p<0.001). The decrease in WC (-5.6 cm; p<0.01) was more pronounced for subjects who completed at least 64% of the planned sessions. CONCLUSION: An AIT program could be implemented in FEP patients and improve WC and cardiorespiratory fitness over a relatively short period.