Nahar Taufiq

Evaluation of various alloys for stent on platelet aggregation activity

Nowadays coronary artheroslerotic disease becomes a primary health problem due to its high morbidity and mortality rate. Such disease is related to the poor coronary blood flow quality. Coronary stent implantation is widely accepted to overcome the problem. There are various alloys available for stent commercially by different prices. This study was aimed to evaluate the various alloys for stent on platelet aggregation activity. The materials used under reseach were stainless-steel of SS 316L (Otocompo, Sweden) and cobalt-chromium of CoCr L605 (Remanium Star, Germany). Twenty eights alloys (14 SS 316L and 14 CoCr L605) were shaped as discs with 10 mm diameter and 2 mm thickness respectively. Venous blood was drawn from medial cubiti vein from 14 subjects of healthy people with neither established atherosclerotic disease nor risk factors. The drawn blood from each subject further be divided into three parts: one part was left without any induction (control), the other two parts were contacted to SS 316L and CoCr L605 respectively. Platelet aggregation activity in all of the samples were then calculated and analyzed by Anova. The result showed the average of platelet aggregation activity in percentage (%) were 89.96±17.93 (control), 80.16±22.04 (CoCr L605), and 80.91±20.68 (SS 316L). The Anova showed p>0.05. In conclusion, stainless-steel of SS 316L and cobalt-chromium of CoCr L605 did not affect platelet aggregation activity on healthy subject; therefore, both of the alloys were potential to be used as material choices for stent devices. Further research is needed to evaluate the effect of both alloys on atherosclerotic patients.

Anomalous Origination of Right Coronary Artery from Left Sinus in Asymptomatic Young Male Presenting with Positive Ischemic Response on Treadmill Test

Anomalous origination of coronary artery from the opposite sinus (ACAOS) is a rare coronary artery anomaly. Right ACAOS with interarterial course is a type of ACAOS, which conveys a high risk for myocardial ischemia or sudden death. We reported a case of right ACAOS with interarterial course in otherwise healthy young male. He was asymptomatic, until an obligatory medical check-up with treadmill test showed a sign of positive ischemic response. Further work-up revealed that he had right ACAOS with interarterial course. Watchful observation was applied to him, while strenuous physical activity and competitive sport were absolutely prohibited.

Plaque, Platelets, and Plug – The Pathogenesis of Acute Coronary Syndrome

Acute coronary syndrome is a clinical condition of partial or total obstruction of blood flow in the coronary artery due to acute thrombus formation. Culprit vessel, coronary artery segment within which the site of origin of thrombus formation lies, is occupied by eroded or ruptured atherosclerotic plaque. Direct contact between circulating blood constituent and atherosclerotic plaque content owing to loss of endothelial cell barrier orchestrates the haemostasis events, i.e. thrombus formation and coagulation activation. Evolved within years of human life span, atherosclerotic undergoes three main steps: initiation, progression and finally complication (Libby, 2002). Atherosclerotic plaque development involves cellular and molecular interactions as well as blood flow dynamic alterations in the affected area. Although these steps affect all individual, some gather the risk factors to develop progression and complication of coronary atherosclerotic lesion faster and more prominent than others. Given the dynamic nature of these steps, understanding several mechanisms engage in every step will provide insight into therapeutic approach. Here, we review the last two steps of coronary atherosclerotic plaque development, with the focus in the role of platelets, anucleated cells being the target for therapeutic advancement in atherosclerosis and acute coronary syndrome.