Document Detail


Relationships between homocysteine, factor VIIa, and thrombin generation in acute coronary syndromes.
MedLine Citation:
PMID:  10653827     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It has been suggested by clinical, epidemiological, and experimental in vitro studies that homocysteine potentiates thrombin generation. This prothrombotic effect however has not previously been demonstrated in patients presenting with acute coronary syndromes (ACS). METHODS AND RESULTS: Patients with ACS (n =117) presenting with confirmed acute myocardial infarction (MI) (n =57) or unstable angina pectoris (UAP) (n =60) were consecutively recruited together with patients (n =18) in whom the presenting chest pain was not of cardiac origin (NCP), included as controls. Plasma samples were collected on admission and before clinical intervention. Homocysteine was assayed by high performance liquid chromatography, and both Factor VIIa and prothrombin fragment F1+2 were analyzed by ELISA. There were significant elevations in F1+2 in MI (P<0.001) and UAP (P=0.003), and modest elevations in Factor VIIa in UAP (P<0.05) compared with NCP but no differences in homocysteine levels among those groups. On dividing patients with ACS into quartiles of homocysteine, there was a stepwise increase in F1+2 (P<0.0001) and of Factor VIIa (P<0.05). There were significant correlations in ACS between homocysteine and F1+2 (r=0.46, P<0.0001), homocysteine and Factor VIIa (r=0.24, P<0.01), and F1+2 and Factor VIIa (r=0.41, P<0.0001). There was no correlation between homocysteine and either F1+2 (r=-0.15, P=0.57) or Factor VIIa (r=0. 22, P=0.37) in the NCP patients. CONCLUSIONS: Elevated plasma homocysteine is associated with and may cause elevated Factor VIIa and thrombin generation in patients presenting with ACS. These findings suggest an explanation for the prothrombotic effect of homocysteine in ACS.
Authors:
M K Al-Obaidi; H Philippou; P J Stubbs; A Adami; R Amersey; M M Noble; D A Lane
Related Documents :
3912047 - Exercise regimens after myocardial revascularization surgery: rationale and results.
21904277 - Aerobic training programs and glycemic control in diabetic children in relation to exer...
7136997 - Superiority of selected treadmill exercise protocols predischarge and six weeks postinf...
21861927 - Hypothalamic inflammation is reversed by endurance training in anorectic-cachectic rats.
4028197 - Response of interphasic nucleoli to hypoxia in root meristems.
7887657 - Epiluminescence microscopy. a useful tool for the diagnosis of pigmented skin lesions f...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  101     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-02-18     Completed Date:  2000-02-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  372-7     Citation Subset:  AIM; IM    
Affiliation:
National Heart and Lung Institute, Cardiology and Haematology Departments, Charing Cross Campus, Imperial College School of Medicine, London, UK. m.al-obaidi@rbh.nthames.nhs.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Angina, Unstable / blood*
Biological Markers / blood
Chest Pain
Cholesterol / blood
Cholesterol, HDL / blood
Chromatography, High Pressure Liquid
Diabetes Mellitus / blood
Enzyme-Linked Immunosorbent Assay
Factor VIIa / analysis,  metabolism*
Female
Homocysteine / blood*
Humans
Hypertension / blood
Male
Middle Aged
Myocardial Infarction / blood*
Smoking
Thrombin / analysis,  metabolism*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, HDL; 454-28-4/Homocysteine; 57-88-5/Cholesterol; EC 3.4.21.21/Factor VIIa; EC 3.4.21.5/Thrombin

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


Previous Document:  Cost-effectiveness of platelet glycoprotein IIb/IIIa inhibition with eptifibatide in patients with n...
Next Document:  Effects of metoprolol CR in patients with ischemic and dilated cardiomyopathy : the randomized evalu...