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Fibrinogen, factor VII clotting activity and coronary artery disease severity
P Broadhurst1, C Kelleher, L Hughes
1Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, U.K.
Insights
This study found that higher levels of fibrinogen and factor VII coagulant (VIIc) activity are linked to the extent of coronary artery disease, particularly in patients with a history of myocardial infarction.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Clinical Biochemistry
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- The coagulation system, including fibrinogen and factor VII, plays a role in atherothrombosis.
- Understanding the relationship between coagulation factors and CAD extent is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between fibrinogen, factor VII coagulant (VIIc) activity, and the extent of coronary artery disease.
- To compare coagulation factor levels in patients with and without a history of myocardial infarction (MI).
Main Methods:
- Studied 43 white males with >50% stenosis in at least one major coronary artery.
- Classified patients based on the number of diseased vessels and history of MI.
- Measured plasma fibrinogen levels and factor VIIc activity.
Main Results:
- A significant relationship was observed between atheroma extent and both factor VIIc activity and fibrinogen in patients with prior MI.
- Patients with prior MI showed significantly higher factor VIIc activity than those without MI, even with similar atheroma severity.
- Age, BMI, and blood pressure were comparable between groups.
Conclusions:
- The coagulation system, specifically fibrinogen and factor VIIc, is significantly associated with the extent of coronary artery disease.
- Elevated factor VIIc activity may indicate an increased thrombotic risk in patients with established CAD and prior MI.
- These findings support the role of the coagulation system in the clinical manifestation of CAD.
Abstract:
To asses the relationship between fibrinogen, factor VII coagulant (VIIc) activity and extent of coronary artery disease, we studied 43 white males shown to have greater than 50% stenosis of at least one major coronary artery. Thirty six had a definite history of myocardial infarction at least 3 months earlier and were classified as having 1, 2 or 3 vessel disease while 7 had 2 or 3 vessel disease, but no prior infarction. Groups were similar with regard to age, body mass index and blood pressure. In those with documented prior infarction, there was a significant relationship between the extent of atheroma and coagulation variables factor VIIc and fibrinogen. However, given a similar degree of atheroma, patients with prior infarction had significantly higher levels of factor VIIc activity compared with patients without such a history. These results corroborate those from prospective studies confirming a significant role for the coagulation system in the clinical manifestation of coronary artery disease.