Prothrombotic profile in patients with vasospastic or non vasospastic angina and non significant coronary stenosis

Thrombosis Journal

Original Clinical Investigation

Beatriz Meneses¹  Elsa Nieto¹  Enric Domingo¹  Jaume Figueras¹  Jasone Monasterio¹  Josefa Cortadellas¹  David Garcia-Dorado¹ 

[1] Unitat Coronària, Àrea del Cor, Laboratori d'Hemostàsia*, Hospital General Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain;

关键词: Coronary Artery Disease Patient;    Coronary Thrombosis;    Tissue Factor Pathway Inhibitor;    Coronary Artery Disease Group;    Significant Coronary Stenosis;   

DOI  :  10.1186/1477-9560-9-10

 received in 2010-10-05, accepted in 2011-05-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPatients with vasospastic (VA) or non vasospastic angina (NVA) without significant coronary stenosis have a reduced risk of infarction but is unclear whether or not this may be attributable to a lack of prothrombotic profile - similar to that present in patients with stable coronary artery disease (CAD).MethodsPlasma levels of von Willebrand factor, total and free tissue factor pathway inhibitor, plasminogen activator inhibitor-1, and fibrinogen were analyzed in 15 patients with stable VA and 23 with NVA, all with vasoconstrictive response to acetylcholine although with different severity. Results were compared with those of 20 age-matched controls and 10 patients with CAD.ResultsPlasma levels of von Willebrand factor in patients with VA or NVA were higher than in controls (207 ± 62 and 203 ± 69% vs 121 ± 38%, p < 0.001) and tended to be lower than in CAD patients (264 ± 65, p = 0.145). They also presented higher total tissue factor pathway inhibitor (123 ± 18 and 111 ± 25 vs 88 ± 14, ng/ml p < 0.001) and plasminogen activator inhibitor-1 levels than controls (51 ± 30 and 52 ± 31% vs 19 ± 9 ng/ml, p < 0.001) and similar to CAD patients (134 ± 23 and 62 ± 31, respectively, ns). Moreover, free tissue factor pathway inhibitor plasma levels were lower than controls (18 ± 5 and 17 ± 5 vs 23 ± 8 ng/ml, p = 0.002) and similar to CAD patients (14 ± 5, ns). Despite this prothrombotic condition none of VA or NVA patients presented a myocardial infarction during a 9 year follow-up, an observation also reported in larger series.ConclusionsDuring a stable phase of their disease, patients with VA or NVA present a prothrombotic profile that might eventually contribute to occurrence of myocardial infarction. The rarity of these events, however, may suggests that ill defined factors would protect these patients from coronary plaque rupture/fissure.

【 授权许可】

CC BY   
© Figueras et al; licensee BioMed Central Ltd. 2011