Effect of remote ischaemic conditioning on coagulation and fibrinolysis

被引:12
|
作者
Kristiansen, Jacobina [1 ,2 ]
Grove, Erik L. [1 ,3 ]
Rise, Nina [1 ,2 ]
Neergaard-Petersen, Sos [1 ]
Wurtz, Morten [1 ]
Kristensen, Steen Dalby [1 ,3 ]
Hvas, Anne-Mette [2 ,3 ]
机构
[1] Aarhus Univ Hosp, Dept Cardiol, DK-8200 Aarhus N, Denmark
[2] Aarhus Univ Hosp, Dept Clin Biochem, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
[3] Aarhus Univ, Inst Clin Med, Fac Hlth, Aarhus, Denmark
关键词
Aspirin; Blood coagulation; Fibrinolysis; Remote ischemic conditioning; Thromboelastometry; ELEVATION MYOCARDIAL-INFARCTION; PLASMINOGEN ACTIVATOR RELEASE; CARDIOPROTECTION; HEMOSTASIS; OUTCOMES; ASPIRIN; DISEASE;
D O I
10.1016/j.thromres.2016.03.017
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Remote ischaemic conditioning (RIC) reduces infarct size and may improve prognosis in patients with acute myocardial infarction. To explore the potential mechanisms, we investigated the effects of RIC on coagulation and fibrinolysis. Methods: Interventional crossover study including 30 healthy drug-naive males. Participants were exposed to a sham intervention (visit 1) and to RIC (visit 2 and 3) induced by intermittent arm ischaemia through four cycles of 5-min inflation of a blood pressure cuff followed by 5-min deflation. Prior to visit 3, all participants received aspirin 75 mg daily for seven days. Blood samples were obtained at baseline as well as 5 and 45 min after intervention. Whole blood coagulation was assessed by thromboelastometry (ROTEM (R)) and thrombin generation. Fibrinolysis was evaluated by clot turbidity-lysis, tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1). Results: No differences were found in clot initiation, clot propagation or clot strength evaluated by ROTEM (R) (all p-values >= 0.98). During aspirin treatment, clot initiation and clot propagation decreased after RIC evaluated by ROTEM (R) EXTEM (R) clotting time (p = 0.04) and ROTEM (R) EXTEM (R) maximum velocity (p = 0.03). After sham and RIC, thrombin generation declined as evaluated by reduced endogenous thrombin potential (RIC: p = 0.001) and peak (RIC: p = 0.01). After RIC during aspirin treatment, changes in thrombin generation were inconsistent; increased peak (p = 0.04) and time to peak (p < 0.001) and a decrease in lag-time (p < 0.001). Clot lysis time was prolonged both after sham and after RIC (p < 0.001). After RIC, PAI-1 levels declined (p = 0.03), but t-PA levels also declined after all interventions (p-values = 0.04). Conclusion. RIC did not have substantial effects on coagulation or fibrinolysis compared to sham. Overall, aspirin did not influence the results. (C) 2016 Published by Elsevier Ltd.
引用
收藏
页码:129 / 135
页数:7
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