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Abstract
Acute myocardial infarction (AMI) is the leading cause of death in patients hospitalized with cardiovascular disease, and one of the most common reasons for emergency department visits. P-selectin, (CD 62p), is a member of the selectin family contained in the platelet alpha granules and in the wibel-palade bodies of endothelial cells. Increased levels of serum P-selectin have been observed in several vascular diseases such as myocardial infarction. As serum p-selectin has been proposed to reflect the functional status of platelets and endothelial. The current study aimed to measure serial changes in serum P-selectin(at the time of presentation and after three hours and after twenty four hours) in patients with acute myocardial infarction (aMI) undergoing thrombolytic therapy, and to identify a possible relationship between the success of thrombolytic therapy and serum P-selectin levels.This work performed on 20 patients of acute myocardial infarction presented by typical cardiac chest pain, and 20 subject as control, 10 of them have stable angina and the other are healthy . Candidates of the present study were subjected to clinical evaluation including history taking, clinical examination and cardiac investigations (ECG) and determination of platelet count, total leukocytes count, lipid profile, CPK and serum p-selectin by ELISA. There was no statistical significant difference between the three studied groups regarding age, systolic and diastolic blood pressure.
As regarding pulse there was statistical significant difference between group I and group III, but there was no statistical comparison difference between group I and group II There was statistical significant difference between the three studied groups as regarding White blood cells As regarding platelets count, there was statistical significant difference between group I and group III and group I and group II but there was no statistical comparison difference between group I and group II. There was statistical significant difference between group I and group III and group II and group III as regarding serum cholesterol level, serum triglycerides but there was no statistical comparison difference between group I and group II There was statistical significant difference between group I and group III and group I and group II as regarding serum LDL but there was no statistical comparison difference between group II and group III. There was statistical significant difference between group I and group III as regarding serum HDL but there was no statistical comparison difference between group I and group II and II &III. There was statistical significant difference between the three studied groups as regarding CPK. There was statistical significant difference between group I and group III and group I and group II as regarding p-selectin but there was no statistical comparison difference between group II and group III. There was positive correlation between p- selectin and serum cholesterol &LDL & TG &white blood cells count &platelets count & age & pulse and CPK. But there was negative correlation between p- selectin and HDL|& systolic BP & diastolic BP.
As regarding failed and success groups There was no statistical significant difference as regarding,pulse,blood pressure,WBCs count, platelet count, number of smokers ,hypertensive patients, serum cholesterol , TG ,LDL , HDL and CPK. But as regarding serial p-selectin also there was no statistical significant difference between tow groups at 1st and 2nd measurements and the difference was significant at 3rd measurement.