Altered fibrin architecture is associated with hypofibrinolysis and premature coronary atherothrombosis
Altered fibrin architecture is associated with hypofibrinolysis and premature coronary atherothrombosis
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DOI：
10.1161/01.atv.0000241589.52950.4c
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发表时间：
2006-11-01
影响因子：
8.7
通讯作者：
Montalescot, G.
中科院分区：
文献类型：
--
作者：
Collet, J. P.;Allali, Y.;Montalescot, G.
目的：纤溶功能减退促进早发冠心病患者动脉粥样硬化进展和缺血性事件复发.我们调查了纤维蛋白的物理性质在这个特殊setting.Methods和结果的作用-复发性血栓形成和早发性冠状动脉疾病（CAD）的生物标志物进行了测量，在33个年轻的心肌梗死后患者与血管造影证实的CAD和33名健康志愿者的年龄和性别相匹配。通过使用扭摆和光学共聚焦显微镜测量纤维蛋白刚性和纤维蛋白形态学特性来评估离体血浆纤维蛋白物理特性。纤维蛋白溶解速率来自加入溶解酶后连续监测粘弹性。青年冠心病患者血浆纤维蛋白原、血管性血友病因子、纤溶酶原激活物抑制物1和脂蛋白（a）浓度较对照组显著升高（P < 0.05）。年轻CAD患者的纤维较硬（P = 0.002），由大量（P = 0.002）和较短的纤维（P = 0.04）组成，并且溶解速率低于对照组（P = 0.03）。纤维蛋白硬度是一个独立的预测因素，为过早CAD和hypofibrinolysis.Conclusions -这第一次详细研究凝块性质在这样一组患者表明，异常血浆纤维蛋白结构是一个重要的特点，过早CAD和纤溶率。这种特殊表型的决定因素值得进一步研究。
Objective - Hypofibrinolysis promotes atherosclerosis progression and recurrent ischemic events in premature coronary artery disease. We investigated the role of fibrin physical properties in this particular setting.Methods and Results - Biomarkers of recurrent thrombosis and premature coronary artery disease ( CAD) were measured in 33 young post - myocardial infarction patients with angiographic- proven CAD and in 33 healthy volunteers matched for age and sex. Ex vivo plasma fibrin physical properties were assessed by measuring fibrin rigidity and fibrin morphological properties using a torsion pendulum and optical confocal microscopy. The fibrinolysis rate was derived from continuous monitoring of the viscoelastic properties after addition of lytic enzymes. Young CAD patients had a significant increase in plasma concentration of fibrinogen, von Willebrand factor, plasminogen activator inhibitor type 1, and lipoprotein( a) as compared with controls ( P < 0.05). Fibrin of young CAD patients was stiffer ( P = 0.002), made of numerous ( P = 0.002) and shorter fibers ( P = 0.04), and lysed at a slower rate than that of controls ( P = 0.03). Fibrin stiffness was an independent predictor for both premature CAD and hypofibrinolysis.Conclusions - This first detailed study of clot properties in such a group of patients demonstrated that abnormal plasma fibrin architecture is an important feature of both premature CAD and fibrinolysis rate. The determinants of this particular phenotype warrant further investigation.