Haemostatic markers, inflammatory parameters and lipids in male and female patients in the Angina Prognosis Study In Stockholm (APSIS). A comparison with healthy controls

OBJECTIVES: To investigate haemostatic markers (especially fibrinolysis), inflammatory parameters and lipids in patients with stable angina pectoris. Special attention was paid to differences between male and female patients, and to the reactivity to exercise or the diurnal variation of certain parameters. SUBJECTS: Eight hundred and nine patients (31% females) and a matched healthy control group (n = 50). RESULTS: The patients had signs of disturbed fibrinolysis, with elevated plasma levels of tissue plasminogen activator (tPA) antigen and plasminogen activator inhibitor (PAI-1) activity at rest, and attenuated responses of tPA antigen and activity to exercise. Elevated levels of fibrinogen, white blood cell counts and orosomucoid were found, suggesting increased inflammatory activity, as well as a more disturbed lipid profile (higher triglycerides and lower HDL cholesterol levels) than among controls. Female patients had higher HDL cholesterol and lower triglyceride levels than male patients, but higher platelet counts and signs of enhanced platelet activity (beta-thromboglobulin excretion). In addition, female patients had lower white blood cell counts, suggesting lesser inflammatory activity. CONCLUSIONS: Patients with stable angina pectoris have signs of markedly disturbed fibrinolysis both at rest and in response to exercise, as well as signs of enhanced inflammatory activity and dyslipidemia. The observed sex differences suggest that male patients with stable angina pectoris may have a more lipid-related disease, whereas it may be more dependent on platelet function in females.