Document Detail


Serum lipoprotein(a) level is related to thrombin generation and spontaneous intermittent coronary occlusion in patients with acute myocardial infarction.
MedLine Citation:
PMID:  8901653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thrombotic occlusion of the infarct-related coronary artery is often intermittent in the early, evolving phase of acute myocardial infarction. To assess their relationship to this pattern of coronary occlusion, serum or plasma concentrations of cholesterol, triglyceride, lipoprotein(a), and coagulation and fibrinolytic factors were measured in venous blood before the initiation of thrombolytic therapy. METHODS AND RESULTS: Thirty-two patients (23 men, 9 women: age, 30 to 70 years) with acute myocardial infarction received intravenous recombinant tissue plasminogen activator (20 to 60 megaunits) within 6 hours of the onset of symptoms. Continuous ECG ST-segment recording demonstrated intermittent occlusion of the infarct-related coronary artery in 12 patients (group 1) before the start of thrombolytic treatment and persistent occlusion in 20 patients (group 2). Groups 1 and 2 were similar in age, sex, race, duration of symptoms, blood sample collection time, location of the infarct-related coronary artery, and extent of coronary artery disease. The serum level (median [interquartile range]) of lipoprotein(a) was 34 (13 to 47) mg/dL versus 11.5 (5 to 27) mg/dL (P = .02), and the plasma level (median [interquartile range]) of thrombin-antithrombin III complex was 10.85 (6.4 to 21.5) versus 6.8 (4.2 to 8.7) micrograms/L-1 (P < .04) in groups 1 and 2, respectively. The levels of the other factors were similar in both groups. CONCLUSIONS: The phenomenon of spontaneous intermittent closure and reopening of coronary arteries early during acute myocardial infarction in humans is associated with a higher level of lipoprotein(a) and of a marker of thrombin generation, suggesting that lipoprotein(a) and thrombin are closely related to coronary patency in these patients.
Authors:
A W Haider; F Andreotti; G R Thompson; C Kluft; A Maseri; G J Davies
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  94     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1996-12-06     Completed Date:  1996-12-06     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2072-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Clinical Cardiology, Royal Postgraduate Medical School, Hammersmith Hospital, London, England. AGHA@FRAM.NHLBI.NIH.GOV
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Biological Markers
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Coronary Disease / blood*,  complications
Electrocardiography
Female
Fibrinogen / metabolism
Fibrinolysin / metabolism
Hemostasis / physiology
Humans
Lipids / blood
Lipoprotein(a) / blood*
Male
Middle Aged
Myocardial Infarction / blood*,  etiology
Plasminogen Activators / administration & dosage
Thrombin / biosynthesis*
Time Factors
Tissue Plasminogen Activator / administration & dosage
Triglycerides / blood
von Willebrand Factor / metabolism
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Lipids; 0/Lipoprotein(a); 0/Triglycerides; 0/von Willebrand Factor; 9001-32-5/Fibrinogen; EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.5/Thrombin; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.7/Fibrinolysin

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


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