Acute myocardial infarction as a systemic prothrombotic condition evidenced by increased von Willebrand factor protein over ADAMTS13 activity in coronary and systemic circulation
Acute myocardial infarction as a systemic prothrombotic condition evidenced by increased von Willebrand factor protein over ADAMTS13 activity in coronary and systemic circulation
复制标题
DOI：
10.1007/s00380-008-1053-x
复制
发表时间：
2008-09-01
影响因子：
1.5
通讯作者：
Saito, Yoshihiko
中科院分区：
文献类型：
--
作者：
Horii, Manabu;Uemura, Shiro;Saito, Yoshihiko
本研究旨在探讨循环中ADAMTS 13和血管性血友病因子（VWF）在急性心肌梗死（AMI）冠状动脉血栓形成中的作用。26例AMI患者，37例年龄匹配的健康对照者和20例年轻对照者进行了研究。在AMI急性期经皮冠状动脉介入治疗（PCI）前即刻和6个月后，分别测定股静脉（FV）、主动脉根（Ao）和冠状静脉窦（Cs）血浆ADAMTS 13活性、VWF抗原（VWF：Ag）和异常大VWF多聚体（UL-VWFM）水平。AMI急性期血浆VWF：Ag水平在FV、Ao和Cs中无显著差异，但均高于同龄对照组。相比之下，AMI患者三个采样点的ADAMTS 13活性与年龄匹配的对照组相似。因此，VWF：在AMI急性期，所有三个采样点的Ag至ADAMTS 13活性均显著高于年龄匹配的对照组。在慢性期，血浆VWF：Ag水平，ADAMTS 13活性，和VWF：Ag与ADAMTS 13活性的比值与年龄匹配的对照组相似。UL-VWFM在急性期检测到，而在慢性期未检测到。本研究表明，血浆VWF：Ag水平增加，ADAMTS 13活性相对降低，在体循环和冠状动脉循环在急性期的AMI，这表明之间的酶和其底物的不平衡可能在冠状动脉闭塞性血栓的形成中发挥作用。
The aim of the present study is to clarify the roles of circulating ADAMTS13 and von Willebrand factor (VWF) in the formation of coronary artery thrombi in acute myocardial infarction (AMI). Twenty-six AMI patients, 37 age-matched healthy controls, and 20 young controls were studied. Plasma ADAMTS13 activity and levels of VWF antigen (VWF: Ag) and unusually large VWF multimer (UL-VWFM) were measured in the femoral vein (FV), aortic root (Ao), and coronary sinus (Cs) immediately before percutaneous coronary intervention (PCI) during the acute phase of AMI, as well as 6 months later. During the acute phase of AMI, plasma levels of VWF: Ag were similar in FV, Ao, and Cs, and were higher than those of age-matched control. In contrast, ADAMTS13 activity in three sampling points in AMI patients was similar to that of age-matched controls. Thus, the ratio of VWF: Ag to ADAMTS13 activity in the acute phase of AMI was significantly higher in all three sampled sites than that of age-matched controls. In the chronic phase, plasma levels of VWF: Ag, ADAMTS13 activity, and the ratio of VWF: Ag to ADAMTS13 activity were similar to those of age-matched controls. UL-VWFM was detected in the acute phase of AMI but not in the chronic phase. The present study showed that the plasma VWF: Ag levels are increased and ADAMTS13 activity is relatively decreased in both systemic and coronary circulation during the acute phase of AMI, suggesting that an imbalance between the enzyme and its substrate may play a role in the formation of occlusive thrombi in a coronary artery.