PERSISTENT ACTIVATION OF COAGULATION MECHANISM IN UNSTABLE ANGINA AND MYOCARDIAL-INFARCTION
PERSISTENT ACTIVATION OF COAGULATION MECHANISM IN UNSTABLE ANGINA AND MYOCARDIAL-INFARCTION
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DOI：
10.1161/01.cir.90.1.61
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发表时间：
1994-07-01
期刊：
影响因子：
37.8
通讯作者：
ROSENBERG, RD
中科院分区：
文献类型：
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作者：
MERLINI, PA;BAUER, KA;ROSENBERG, RD
背景不稳定型心绞痛和急性心肌梗死患者急性期凝血系统处于激活状态。然而，目前尚不清楚止血机制的增强功能是否仅作为急性血栓形成的标志，或者高凝状态是否在临床稳定后持续较长时间。方法与结果我们前瞻性地检测了连续出现不稳定型心绞痛(n=80)和急性心肌梗死(n=32)患者的血浆凝血酶原片段1+2(F-1+2)和纤维蛋白肽A(FPA)的浓度。6个月后，对临床病程平稳的患者(不稳定型心绞痛57例，心肌梗死23例)进行重复血浆检测。对年龄、性别匹配的稳定型心绞痛患者(n=37)和健康人(n=32)的血浆F-1+2和FPA水平进行定量检测。不稳定型心绞痛(F1+2)、急性心肌梗死(F1+2)和急性心肌梗死(F1+2)患者血浆F-1+2和FPA浓度的中位数(F-1+2，1.08nmol/L；FPA，2.4nmol/L；FPA，3.55nmol/L)显著高于稳定型心绞痛患者(F1+2，0.74nmol/L；FPA，1.3nmol/L；P
Background The blood coagulation system is activated in the acute phase of unstable angina and acute myocardial infarction. However, it remains unclear whether augmented function of the hemostatic mechanism serves only as a marker of the acute thrombotic episode or whether a hypercoagulable state persists for a prolonged period after clinical stabilization.Methods and Results We prospectively measured the plasma concentrations of prothrombin fragment 1+2 (F-1+2) and fibrinopeptide A (FPA) in consecutive patients presenting with unstable angina (n=80) or acute myocardial infarction (n=32), respectively. At 6 months, plasma determinations were repeated in patients experiencing an uneventful clinical course (unstable angina, n=57; myocardial infarction, n=23). We quantitated the plasma levels of F-1+2 and FPA in control patients with stable angina (n=37) or healthy individuals (n=32) who were matched for age and sex. The median plasma concentrations of F-1+2 and FPA are significantly higher in patients presenting with unstable angina (F-1+2, 1.08 nmol/L; FPA, 2.4 nmol/L) or acute myocardial infarction (F-1+2, 1.27 nmol/L; FPA, 3.55 nmol/L) compared with patients with stable angina (F-1+2, 0.74 nmol/L; FPA, 1.3 nmol/L; P