Changes of cardiac structure and function in patients with acute coronary syndrome and different Rho kinase activities after treatment with dual anti-platelet aggregation

Yang Xianyi; Liu Mei; Chai Lin; Xiao Min; Zhou Ming; Xie Hua

doi:10.3969/j.issn.1674-4055.2017.11.07

Abstract：Objective To investigate the changes of cardiac structure and function in patients with acute coronary syndrome (ACS) and different Rho kinase activities after treatment with dual anti-platelet aggregation. Methods ACS patients (n=150) were chosen from Taihe Hospital of Shiyan City from Mar. 2015 to Feb. 2016, and divided, according to Rho kinase activity (dividing value=2.45), into low-activity group (<2.45) and high-activity group (≥2.45). All groups were treated with aspirin and clopidogrel. The changes of Rho kinase activity were observed and compared in 2 groups at time points of hospitalization and aspirin-clopidogrel treatment for 3 months and 12 months. The changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) and left cardiac structure and function, including left atrial diameter (LAD), left ventricular end-diastolic inner diameter (LVEDD), left ventricular ejection fraction (LVEF) and cardiac index (CI), were reviewed. The incidence of major adverse cardiovascular events (MACE) was compared. Results Rho kinase activity and NT-proBNP level were significantly higher in high-activity group than those in low-activity group at 3 time points (all P<0.05). The difference in LAD, LVEDD, LVEF and CI had no statistical significance between 2 groups at time of hospitalization (P>0.05). After treatment for 3 months and 12 months, LAD and LVEDD were significantly higher, and LVEF and CI were lower in high-activity group than those in low-activity group (all P<0.05). The level of high sensitivity C-reactive protein (hs-CRP) was higher in high-activity group than that in low-activity group at 3 time points (P<0.05). The incidence of MACE was 30.77% in high-activity group and 6.94% in low-activity group (P<0.05). Conclusion The curative effect of dual anti-platelet aggregation is higher in ACS patients with lower Rho kinase activity than that in those with higher Rho kinase activity.