July 1, 1989British Journal of Haematology
Factor VII and extrinsic pathway inhibitor in acute coronary disease
Why the study?
Are coagulation factor VII and extrinsic pathway inhibitor levels altered in patients with acute ischaemic heart disease compared to normal individuals?
Population
68 patients with acute ischaemic heart disease and 37 normal individuals
Design
Case-control
Authors
Discussion
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Member takes
Implication
May reflect balanced extrinsic pathway activation in acute ischemic syndromes; leaves open prospective validation for risk stratification or therapy.
Key Points
- To evaluate the activation of coagulation factor VII and the counteracting extrinsic pathway inhibitor in patients experiencing acute ischemic heart disease.
- Measured factor VII clotting and amidolytic activities alongside extrinsic pathway inhibitor (EPI) in plasma from 68 patients (acute myocardial infarction, angina pectoris, and heart failure/arrhythmia) and 37 healthy controls.
- Determined the phospholipase C-sensitive factor VII-phospholipid complex fraction and assessed its correlation with plasma triglyceride concentrations.
- The phospholipase C-sensitive factor VII-phospholipid complex rose to 19% in acute myocardial infarction versus 8% in controls (P < 0.05) and correlated strongly with triglycerides in infarction (r = 0.88, P < 0.001) and angina (r = 0.89, P < 0.001).
- EPI levels increased significantly in acute myocardial infarction (132%), angina (134%), and heart failure (150%) compared to controls (110%), significantly lowering the factor VII clotting/EPI ratio in infarction and heart failure.
Structured PICO
Are coagulation factor VII and extrinsic pathway inhibitor levels altered in patients with acute ischaemic heart disease compared to normal individuals?
P
Population
68 patients with acute ischaemic heart disease (acute myocardial infarction, angina pectoris, heart failure/arrhythmia) and 37 normal individuals
C
Comparator
37 normal individuals
O
Outcome
Levels of coagulation factor VII (FVII) and extrinsic pathway inhibitor (EPI)surrogate
In patients with acute ischaemic heart disease, a moderate increase in procoagulant activity is accompanied by a marked increase in anticoagulant activity of the extrinsic coagulation pathway, suggesting a balanced activation system.
Cite This Study
Sandset et al. (1989) studied this question.