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Application of thrombin-antithrombin III complex for detecting a latent hypercoagulable state in patients with
1Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan.
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Plasma thrombin-antithrombin III complex (TAT) is a sensitive marker for hypercoagulable states in coronary artery disease (CAD) patients. Elevated TAT levels before and after exercise indicate latent coagulation activation in CAD.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Clinical Biochemistry
Background:
- Coronary artery disease (CAD) pathogenesis is linked to hypercoagulable states.
- Sensitive markers for detecting hypercoagulability in CAD are limited.
Purpose of the Study:
- To investigate plasma thrombin-antithrombin III complex (TAT) levels in CAD patients.
- To assess TAT as a marker for latent coagulation activation before and after exercise.
Main Methods:
- Measured plasma TAT levels in 18 CAD patients and 12 healthy controls.
- Administered a submaximal exercise test to all participants.
- Compared TAT levels pre- and post-exercise between groups.
Main Results:
- CAD patients exhibited significantly higher plasma TAT levels than controls, both before and after exercise.
- TAT levels increased markedly in both groups post-exercise, with a greater rise in CAD patients.
- Other coagulation parameters (PT, aPTT, ATIII, fibrinogen, FDP, etc.) showed no significant group differences.
Conclusions:
- Plasma TAT is a sensitive marker for latent blood coagulation activation.
- Patients with CAD appear to be in a latent hypercoagulable state, detectable by TAT levels.
Abstract:
It is thought that a hypercoagulable state contributes to the pathogenesis of coronary artery disease (CAD), but few sensitive markers have been available for detecting the state. In the present study the plasma level of thrombin-antithrombin III complex (TAT), a specific indicator of thrombin generation in blood, was investigated before and after a submaximal exercise test in 18 patients with CAD and in 12 healthy controls. The mean (+/- SEM) value of plasma TAT before the exercise was 3.30 (0.81) ng/ml in the patient group and 1.49 (0.08) ng/ml in controls, and its level increased to 29.22 (5.74) ng/ml and 12.07 (2.89) ng/ml after the exercise, respectively. Thus, the TAT value in the patient group was higher than that in the controls both before and after the exercise. However, no differences could be found between the groups in the following parameters; prothrombin time, activated partial thromboplastin time, antithrombin III, fibrinogen, FDP, plasminogen, alpha 2-plasmin inhibitor, and alpha 2-macroglobulin. Through these results it was concluded that plasma TAT level could be a sensitive marker for latent activation of blood coagulation, and also that the results of these experiments showed that patients with CAD were in a latent hypercoagulable state.