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Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Thrombogenic factors and recurrent coronary events
A J Moss1, R E Goldstein, V J Marder
1Cardiology and Vascular Medicine, Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA.
Circulation
|May 20, 1999
Summary
Elevated D-dimer and apoB, along with low apoA-I, predict recurrent coronary events in post-myocardial infarction patients. These blood factors indicate a procoagulant state and disordered lipid transport, increasing risk.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Clinical Biochemistry
Background:
- Thrombosis is central to coronary artery disease pathogenesis.
- Identifying risk factors for recurrent events post-myocardial infarction is crucial.
Purpose of the Study:
- To investigate the association between thrombotic and lipid blood factors and recurrent coronary events in post-myocardial infarction patients.
Main Methods:
- Prospective enrollment of 1045 patients 2 months post-myocardial infarction.
- Measurement of hemostatic (D-dimer, fibrinogen, factor VII, factor VIIa, von Willebrand factor, PAI-1), lipid (cholesterol, triglycerides, HDL, LDL, Lp(a), apoA-I, apoB), and insulin levels.
- Follow-up for an average of 26 months with coronary death or nonfatal myocardial infarction as the primary endpoint; Cox survivorship model used.
Main Results:
- High D-dimer levels (HR 2.43) were independently associated with recurrent events.
- High apoB levels (HR 1.82) and low apoA-I levels (HR 1.84) were also independently linked to increased risk.
- Associations remained significant after adjusting for clinical covariates.
Conclusions:
- Elevated D-dimer indicates a procoagulant state contributing to recurrent coronary events.
- Disordered lipid transport, shown by low apoA-I and high apoB, independently increases risk in post-infarction patients.
- These biomarkers offer valuable insights into secondary prevention strategies.
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