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Lower tissue factor inhibition in patients with ST segment elevation than in patients with non ST elevation acute myocardial infarction.
MedLine Citation:
PMID:  22424853     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Mechanisms to explain the different course of coronary thrombosis between ST elevation myocardial infarction (STEMI) and non-STEMI patients remain poorly defined. We hypothesize, however, that STEMI patients may present lower tissue factor plasma inhibition to partly account for their more persistent coronary thrombotic occlusion. MATERIALS AND METHODS: Total (t-TFPI ) and free tissue factor plasma inhibitor (f-TFPI), thrombin-antithrombin complex (TAT), plasminogen activator inhibitor 1 (PAI-1), von Willebrand factor (vWF), and fibrinogen were measured on admission and at 3 and 6months in patients with a first STEMI (n:69) or non-STEMI (n:60). C reactive protein (CRP) was also measured on admission and at 3months. RESULTS: STEMI patients showed lower admission levels of t-TFPI (p=0.001), f-TFPI (p=0.030) and fibrinogen (p=0.022), and higher vWF levels (p=0.005) than non-STEMI whereas TAT, PAI and CRP levels were comparable. At 3 and 6months VWF, t-TFPI, f-TFPI, and TAT levels declined significantly in the 2 groups (p=0.002) reaching similar values. CRP levels also declined at 3months (p=0.002). Moreover, the rate of cardiac mortality, non fatal MI or stroke during a 6year follow-up were unrelated to admission coagulation parameters. CONCLUSIONS: The lower inhibition of tissue factor and greater endothelial dysfunction in STEMI than in non-STEMI patients may enhance thrombosis at the culprit lesion and adjacent coronary plaques, and hence, account at least in part for their different pathophysiology. This condition, however, is limited to the acute phase.
Authors:
Jaume Figueras; Jasone Monasterio; Rosa M Lidón; Antonia Sambola; David Garcia-Dorado
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-15
Journal Detail:
Title:  Thrombosis research     Volume:  -     ISSN:  1879-2472     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
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