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Evaluation of factors predisposing to arterial thrombosis in coronary artery disease
R Saxena1, K K Talwar, V K Kotte
1Department of Haematology, All India Institute of Medical Sciences, New Delhi.
Insights
Patients with angina and myocardial infarction show reduced antithrombin III (AT III) levels, indicating a potential for blood clots. Elevated platelet factor 4 (PF4) suggests increased platelet activation during acute phases of coronary artery disease.
Area of Science:
- Cardiology
- Hematology
- Biochemistry
Background:
- Coronary artery disease (CAD) involves complex pathophysiological processes including thrombosis and inflammation.
- Understanding the role of specific proteins and platelet activation markers is crucial for assessing disease severity and risk.
Purpose of the Study:
- To investigate levels of antithrombin III (AT III), alpha 2 macroglobulin, and alpha 1 antitrypsin in patients with stable angina, unstable angina, and acute myocardial infarction (MI).
- To assess the correlation of these markers and platelet factor 4 (PF4) with different stages of CAD.
Main Methods:
- Quantitative analysis of AT III, alpha 2 macroglobulin, and alpha 1 antitrypsin in patient cohorts (n=15 each) and healthy controls (n=20).
- Measurement of PF4 levels in subgroups of patients (n=10 each) and controls.
- Statistical comparison of marker levels between patient groups and controls.
Main Results:
- Significantly elevated mean PF4 levels were observed in acute myocardial infarction (48.4 ng/ml) and unstable angina (44.7 ng/ml) patients compared to controls (25.42 ng/ml; P < 0.01).
- Mean AT III levels were markedly reduced in patients with MI (39.65%), unstable angina (37.9%), and stable angina (in 9 patients).
- Alpha 1 antitrypsin and alpha 2 macroglobulin levels did not show significant differences compared to healthy subjects.
Conclusions:
- Reduced AT III levels in coronary artery disease patients suggest a prethrombotic state.
- Elevated PF4 levels during the acute phase indicate heightened platelet activation in myocardial infarction and unstable angina.
- These findings highlight the potential of AT III and PF4 as biomarkers in assessing thrombotic risk in CAD.
Abstract:
Estimation of antithrombin III, alpha 2 macroglobulin and alpha 1 antitrypsin in patients with stable and unstable angina and acute myocardial infarction (15 cases each) were carried out. Twenty age, sex and weight matched healthy subjects were included as controls. Mean platelet factor 4(PF4) levels measured in 10 cases of each subgroup were significantly elevated in myocardial infarction (MI) (48.4 +/- 15.16 ng/ml) and III unstable angina patients (44.7 +/- 15.9 ng/ml) as compared to controls (25.42 +/- 12.47 ng/ml; P less than 0.01). Mean antithrombin III (AT III) levels were markedly reduced in all patients with MI (39.65 +/- 12.8% of normal pooled plasma) and unstable angina (37.9 +/- 16.6% of normal pooled plasma) and in 9 patients with stable angina. Alpha I antitrypsin and alpha 2 macroglobulin levels in these cases showed no significant difference compared to normals. Reduced AT III in coronary artery disease suggests a prethrombotic tendency in these patients. Raised PF4 levels in acute phase of the disease suggests heightened platelet activation.