Document Detail

Do plasma biomarkers of coagulation and fibrinolysis differ between patients who have experienced an acute myocardial infarction versus stable exertional angina?
MedLine Citation:
PMID:  18035075     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Circulating concentrations of proteins associated with coagulation and fibrinolysis may differ between individuals with coronary artery disease (CAD) who develop an acute myocardial infarction (AMI) rather than stable exertional angina. METHODS: We compared plasma concentrations of fibrinogen, d-dimer, tissue-type plasminogen activator, and plasminogen activator inhibitor-1 (PAI-1) between patients whose first clinical manifestation of CAD was an AMI (n = 198) rather than stable exertional angina (n = 199). We also compared plasma concentrations of these proteins between patients with symptomatic CAD (either AMI or stable angina; n = 397) and healthy, control subjects (n = 197) to confirm the sensitivity of these assays to detect epidemiologic associations. RESULTS: At a median of 15 weeks after presentation, patients with AMI had slightly higher d-dimer concentrations than patients with stable angina (P = .057), but were not significantly different in other markers. By contrast, fibrinogen, d-dimer, and tissue-type plasminogen activator were significantly higher (P < .001) and PAI-1 lower in patients with CAD than in healthy control subjects. After statistical adjustment for clinical covariates, cardiac risk factors, medications, and other confounders, fibrinogen, d-dimer, and PAI-1 remained significantly associated with CAD. CONCLUSION: Selected plasma markers of coagulation and fibrinolysis did not distinguish patients presenting with AMI from those with stable exertional angina.
Haruka Itakura; Burton E Sobel; Derek Boothroyd; Lawrence L Leung; Carlos Iribarren; Alan S Go; Stephen P Fortmann; Thomas Quertermous; Mark A Hlatky;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  154     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2007-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1059-64     Citation Subset:  AIM; IM    
Stanford University School of Medicine, Stanford, CA 94305-5405, USA.
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MeSH Terms
Analysis of Variance
Angina Pectoris / blood*
Biological Markers / blood
Blood Coagulation Factors / analysis*
Case-Control Studies
Cohort Studies
Fibrin Fibrinogen Degradation Products / analysis*
Fibrinogen / analysis
Middle Aged
Myocardial Infarction / blood*
Plasminogen Activator Inhibitor 1 / blood
Tissue Plasminogen Activator / blood
Reg. No./Substance:
0/Biological Markers; 0/Blood Coagulation Factors; 0/Fibrin Fibrinogen Degradation Products; 0/Plasminogen Activator Inhibitor 1; 0/fibrin fragment D; 9001-32-5/Fibrinogen; EC Plasminogen Activator

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