New and rapid diagnostic method for cardiovascular disease and prothrombotic state

因子VII（FVII）在组织因子诱导的凝血途径的启动中起重要作用，并且已提出FVII凝血活性（FVIIc）的增加是冠状动脉疾病的独立危险因素。然而，尚不确定高FVIIc水平是由于FVII活化增加还是由于FVII质量浓度增加。我们开发了一种新的荧光检测血浆激活的FVII（FVIIa）使用可溶性组织因子。该测定法的灵敏度范围为每毫升血浆0.2至1，000 ng FVIIa。在110名健康受试者和93名高血压、糖尿病和/或心血管疾病患者中测量血浆FVIIa水平。日本健康个体的平均血浆FVIIa水平为2.5 ng/ml，低于西方受试者。年龄增加FVIIa水平和FVII质量，而绝经主要增加FVII质量。老年冠心病和/或慢性脑梗死患者血浆FVIIa水平和FVIIa/FVIIag比值升高。高FVIIa老年组的动脉心血管疾病比低FVIIa老年组更常见。血浆FVIIa水平与血清总胆固醇或甘油三酯水平不相关。老年人FVIIa水平及FVIIa/FVIIag比值与纤维蛋白原水平呈正相关，与体重指数、血清白蛋白水平呈负相关。总之，衰老、心血管疾病和营养不良增加血浆FVIIa水平。FVIIa水平与血脂水平和肝脏合成活性无关，表明FVIIa可能是心血管疾病的独立危险因素。

Factor VII (FVII) plays an important role in initiation of the tissue factor-induced coagulation pathway and an increase in FVII coagulant activity (FVIIc) has been proposed as an independent risk factor for coronary artery disease. However, it remains uncertain whether high FVIIc levels are due to an increase in the activation of FVII or due to an increase in the concentration of FVII mass. We developed a new fluorogenic assay for plasma activated FVII (FVIIa) using soluble tissue factor. The sensitivity of this assay ranged from 0.2 to 1,000 ng of FVIIa per milliliter of plasma. Plasma FVIIa levels were measured in 110 healthy subjects and 93 patients with hypertension, diabetes mellitus, and/or cardiovascular disease. The mean plasma FVIIa level in healthy Japanese individuals was 2.5 ng/ml and it was lower than that in Western subjects. Aging increased both the FVIIa level and FVII mass, while menopause mainly increased the FVII mass. Elderly patients with coronary artery disease and/or chronic cerebral infarction showed an increase in the plasma FVIIa levels and the FVIIa/FVIIag ratio. Arterial cardiovascular disease was more common in a high-FVIIa elderly group than in a low-FVIIa elderly group. Plasma FVIIa levels were not correlated with the serum levels of total cholesterol or triglycerides. The FVIIa level and the FVIIa/FVIIag ratio were positively correlated with the fibrinogen level and were negatively correlated with the body mass index and the serum albumin level in the elderly. In conclusion, aging, cardiovascular disease, and malnutrition increased the plasma FVIIa level. FVIIa levels were not correlated with the levels of lipids and the activity of hepatic synthesis, indicating that FVIIa may be an independent risk factor for cardiovascular disease.