Document Detail


Low normal level of protein C or of antithrombin increases risk for recurrent cardiovascular events.
MedLine Citation:
PMID:  15870547     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relationship between haemostatic factors and recurrent cardiovascular events was investigated in patients enrolled with acute coronary syndrome (acute non-Q myocardial infarction or unstable angina pectoris). One hundred and fifteen patients, aged 64 +/- 10 years, were included in the study. Haemostatic parameters [prothrombin time, activities of factor VII, factor VIII, factor X, antithrombin (AT) and protein C (PC), and concentrations of free protein S, fibrinogen, D-dimer, prothrombin fragment 1+2, and thrombin-antithrombin complex] were measured four times: within 48 h of hospitalization, at discharge (days 5-8), at 3 months and after 1 year. Screening for factor V Leiden mutation was also performed. Patients were followed for cardiovascular endpoints (new or refractory unstable angina pectoris, non-fatal myocardial infarction, stroke, or death) for an average of 555 days. Of all patients, 35 had an endpoint during the follow-up ("endpoint" group) and 80 patients did not ("no endpoint" group). Analysing the whole follow-up period, PC (P < 0.01) and AT (P < 0.01) were lower in the "endpoint" than in the "no endpoint" group. With 50% percentiles at enrollment, the odds ratio for getting an endpoint in the low (cut-off value < 100%) versus high PC group was 2.72 (95% confidence interval, 1.18-6.29; P < 0.05). Lower levels of AT (P < 0.05) and PC (P < 0.05) during the whole follow-up were associated with a shorter event-free time. In conclusion, lower PC and AT values, even within the normal range, seem to be associated with elevated risk for recurrent cardiovascular events and shorter event-free time in acute coronary syndrome patients.
Authors:
K Markus Pelkonen; Ulla Wartiovaara-Kautto; Markku S Nieminen; Kirsi Ahonen; Juha Sinisalo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  16     ISSN:  0957-5235     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-04     Completed Date:  2005-10-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  275-80     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. markuspelkonen@suomi24.fi
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / blood,  etiology
Antithrombin III / analysis*
Cardiovascular Diseases / blood,  epidemiology,  etiology*
Death
Disease-Free Survival
Follow-Up Studies
Hemostasis
Humans
Middle Aged
Myocardial Infarction / blood,  etiology
Odds Ratio
Protein C / analysis*
Recurrence
Risk
Stroke / blood,  etiology
Chemical
Reg. No./Substance:
0/Protein C; 9000-94-6/Antithrombin III

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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