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Elevation of factor VII activity and mass in coronary artery disease of varying severity
T Suzuki1, K Yamauchi, T Matsushita
1First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Insights
Elevated Factor VII levels in coronary artery disease patients are due to increased Factor VII zymogen, not activated Factor VII. This elevation correlates with disease severity and hypercoagulability.
Area of Science:
- Cardiovascular Medicine
- Hematology
Background:
- Coronary artery disease (CAD) is a significant global health concern.
- Factor VII plays a crucial role in the coagulation cascade.
- Previous studies suggest a link between coagulation factors and atherosclerosis.
Purpose of the Study:
- To investigate the correlation between Factor VII levels and the severity of coronary artery disease.
- To determine whether elevated Factor VII in CAD patients is due to zymogen or activated forms.
- To explore the relationship between Factor VII and markers of hypercoagulability.
Main Methods:
- Comparison of Factor VII procoagulant activity (FVII:C) and Factor VII antigen (FVII:Ag) levels in 69 CAD patients with old myocardial infarction and 28 control subjects.
- Calculation of the FVII:C to FVII:Ag ratio.
- Assessment of correlation with thrombin-antithrombin III complexes (TAT).
Main Results:
- CAD patients exhibited elevated FVII:C and markedly elevated FVII:Ag levels compared to controls.
- A decreased FVII:C to FVII:Ag ratio was observed in CAD patients.
- The increase in Factor VII was attributed to elevated Factor VII zymogen, not activated Factor VII.
- FVII:C levels strongly correlated with TAT levels in all patients.
Conclusions:
- The increased Factor VII levels in stable myocardial infarction patients are primarily due to elevated Factor VII zymogen.
- A hypercoagulable state, indicated by increased TAT, underlies the elevation of Factor VII in severe coronary atherosclerosis.
- Findings suggest Factor VII zymogen as a potential biomarker or contributor to CAD pathogenesis.
Abstract:
The present study was undertaken to determine whether the extent of Factor VII elevation correlated with the severity of coronary artery disease and whether zymogen or activated Factor VII was responsible for this elevation. A group of 69 patients with coronary artery disease with old myocardial infarction was compared with 28 control subjects. The patient groups showed elevated levels of Factor VII procoagulant activity (FVII:C) and more markedly elevated Factor VII antigen (FVII:Ag) levels than the control group; therefore they had a decreased FVII:C to FVII:Ag ratio. The increased Factor VII level in the patient groups was caused by elevated Factor VII zymogen levels, and not by activated Factor VII. Since FVII:C levels strongly correlated with the titer of thrombin-antithrombin III complexes in all patients, the hypercoagulable state accompanying severe coronary atherosclerosis seems to underlie the increase of FVII and TAT in the stable phase of myocardial infarction.