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Severity of coronary artery disease and basal fibrinolysis
M Small1, G D Lowe, J M Beattie
1University Department of Medicine, Royal Infirmary, Glasgow, UK.
Insights
This study found no link between fibrinolysis components and coronary artery disease severity. However, plasma fibrinogen showed a modest association with coronary atheroma extent, supporting its role in ischemic heart disease.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biochemistry
Background:
- Coronary artery disease (CAD) involves complex interactions between blood components and vessel health.
- The fibrinolytic system plays a crucial role in dissolving blood clots, and its dysregulation may contribute to cardiovascular events.
Purpose of the Study:
- To investigate the relationship between components of the fibrinolytic enzyme system and the severity of angiographically defined coronary artery disease.
- To explore associations between fibrinogen, triglyceride levels, and fibrinolysis inhibitors with CAD extent.
Main Methods:
- Measurement of basal venous blood levels of fibrinolytic system components (plasminogen activator, plasminogen, fibrin degradation products, alpha 2-antiplasmin, alpha 2-macroglobulin) in 100 white men.
- Assessment of coronary artery disease severity using coronary angiography, number of vessels involved, and a coronary score system.
- Statistical analysis to determine correlations between fibrinolytic tests, fibrinogen, triglyceride levels, and CAD severity.
Main Results:
- Fibrinolytic system tests did not correlate with coronary artery disease severity (vessel involvement or coronary score).
- Plasma fibrinogen levels showed a modest association with the extent of coronary atheroma (r = 0.21, p < 0.05).
- Triglyceride levels were associated with fibrinolysis inhibitors: positively with alpha 2-antiplasmin (r = 0.31, p < 0.005) and negatively with alpha 2-macroglobulin (r = -0.25, p < 0.05). Alpha 2-antiplasmin was elevated in hypertriglyceridemia.
Conclusions:
- The study supports an association between plasma fibrinogen and ischemic heart disease.
- Fibrinolytic enzyme system components do not appear to be directly related to the severity of established coronary artery disease.
- Hypertriglyceridemia is linked to altered levels of fibrinolysis inhibitors, specifically elevated alpha 2-antiplasmin.
Abstract:
Basal venous blood levels of several components of the fibrinolytic enzyme system (plasminogen activator, plasminogen, fibrin degradation products, alpha 2-antiplasmin, and alpha 2-macroglobulin) were measured in 100 white men with angiographically defined coronary artery disease. The tests of fibrinolysis were not related to the severity of coronary artery disease, as indicated either by the number of vessels involved or by a coronary score system. Fibrinogen levels, however, did show a modest association with the extent of coronary atheroma (r = 0.21, p less than 0.05). Triglyceride levels were associated with the inhibitors of fibrinolysis: positively with alpha 2-antiplasmin (r = 0.31, p less than 0.005) and negatively with alpha 2-macroglobulin (r = -0.25, p less than 0.05). The alpha 2-antiplasmin levels were significantly elevated in patients with hypertriglyceridaemia. Neither smoking nor beta-blockade had any effect on the tests of fibrinolysis. This study adds support to the association of plasma fibrinogen with ischaemic heart disease.