Correlation between coronary morphology and molecular markers of fibrinolysis in unstable angina pectoris

被引:19
作者
Hoffmeister, HM [1 ]
Jur, M [1 ]
Helber, M [1 ]
Fischer, M [1 ]
Heller, W [1 ]
Seipel, L [1 ]
机构
[1] Univ Tubingen, Abt Innere Med 3, Med Klin, D-72076 Tubingen, Germany
关键词
unstable angina pectoris; fibrinolytic system; hypercoagulation; coronary artery stenosis morphology;
D O I
10.1016/S0021-9150(99)00049-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: In acute coronary syndromes, marked alterations of coagulation and fibrinolysis have been observed, but no data are available concerning a possible relation to coronary stenosis morphology. Methods: Thirty one patients with unstable angina pectoris were included. Culprit stenosis morphology judged. from coronary angiography was graded using the modified ACC/AHA classification. Molecular and functional markers of hemostasis and fibrinolysis were determined from venous plasma samples obtained at admission. Results: Patients with unstable angina pectoris had a moderate procoagulant state, especially a contact phase activation compared with age-matched controls (factor XII 93.9 +/- 5.6 vs 112.8 +/- 5.4%; P < 0.05; high molecular weight kininogen 55.3 +/- 5.4 vs 86.1 +/- 6.5%; P < 0.01). Thrombin-antithrombin (TAT) was not significantly elevated (7.6 +/- 1.9 vs 4.0 +/- 0.5 mu g/l). Elevated plasminogen activator mass concentration (16.6 +/- 2.1 vs 5.4 +/- 0.6 ng/ml; P < 0.01) and plasminogen activator inhibitor (PAI) activity (9.9 +/- 3.0 vs 5.6 +/- 3.0 AU/ml; P < 0.05) indicated an alteration of the fibrinolysis. Complexity of coronary stenosis was positively correlated with tissue-type plasminogen activator (TPA) mass concentration (P < 0.01) and PAI activity (P < 0.05). No association was found to markers of a hypercoagulative state. Conclusion: These findings indicate a relation between alterations of the fibrinolytic system and coronary morphology, whereas the acute changes of coagulation occur independently of culprit stenosis complexity. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:151 / 157
页数:7
相关论文
共 43 条
[1]   ANGIOGRAPHIC MORPHOLOGY AND THE PATHOGENESIS OF UNSTABLE ANGINA-PECTORIS [J].
AMBROSE, JA ;
WINTERS, SL ;
STERN, A ;
ENG, A ;
TEICHHOLZ, LE ;
GORLIN, R ;
FUSTER, V .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1985, 5 (03) :609-616
[2]   DIURNAL-VARIATION OF TISSUE-TYPE PLASMINOGEN-ACTIVATOR AND ITS RAPID INHIBITOR (PAI-1) [J].
ANGLETON, P ;
CHANDLER, WL ;
SCHMER, G .
CIRCULATION, 1989, 79 (01) :101-106
[3]  
ARDISSINO D, 1991, AM J CARDIOL, V68, pB55
[4]   UNSTABLE ANGINA - A CLASSIFICATION [J].
BRAUNWALD, E .
CIRCULATION, 1989, 80 (02) :410-414
[5]   DISORGANIZATION OF CULTURED VASCULAR ENDOTHELIAL CELL MONOLAYERS BY FIBRINOGEN FRAGMENT-D [J].
DANG, CV ;
BELL, WR ;
KAISER, D ;
WONG, A .
SCIENCE, 1985, 227 (4693) :1487-1490
[6]   RELATION BETWEEN ST SEGMENT SHIFTS DURING ISCHEMIA AND THROMBIN ACTIVITY IN PATIENTS WITH UNSTABLE ANGINA [J].
EISENBERG, PR ;
KENZORA, JL ;
SOBEL, BE ;
LUDBROOK, PA ;
JAFFE, AS .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (04) :898-903
[7]   MORPHOLOGY OF LEFT ANTERIOR DESCENDING CORONARY TERRITORY LESIONS AS A PREDICTOR OF ANTERIOR MYOCARDIAL-INFARCTION - A CASS REGISTRY STUDY [J].
ELLIS, S ;
ALDERMAN, EL ;
CAIN, K ;
WRIGHT, A ;
BOURASSA, M ;
FISHER, L .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 13 (07) :1481-1491
[8]   CORONARY MORPHOLOGICAL AND CLINICAL DETERMINANTS OF PROCEDURAL OUTCOME WITH ANGIOPLASTY FOR MULTIVESSEL CORONARY-DISEASE - IMPLICATIONS FOR PATIENT SELECTION [J].
ELLIS, SG ;
VANDORMAEL, MG ;
COWLEY, MJ ;
DISCIASCIO, G ;
DELIGONUL, U ;
TOPOL, EJ ;
BULLE, TM .
CIRCULATION, 1990, 82 (04) :1193-1202
[9]  
ELMS MJ, 1983, THROMB HAEMOSTASIS, V50, P591
[10]   CORONARY-THROMBOSIS - PATHOGENESIS AND CLINICAL MANIFESTATIONS [J].
FALK, E .
AMERICAN JOURNAL OF CARDIOLOGY, 1991, 68 (07) :B28-B35