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Haemostatic variables in patients with unstable angina
M al-Nozha1, A M Gader, A K al-Momen
1Department of Medicine, College of Medicine, Riyadh, Saudi Arabia.
International Journal of Cardiology
|March 1, 1994
Summary
Unstable angina involves significant clotting system activation and inhibited fibrinolysis, indicating a tendency for thrombus formation. Assays revealed elevated markers of coagulation and platelet activation in patients compared to controls.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Thrombosis Research
Background:
- Unstable angina is a critical manifestation of coronary artery disease.
- Understanding the role of hemostasis in unstable angina pathogenesis is crucial for effective treatment.
- Recent advancements in hemostatic assays allow for detailed assessment of coagulation system activation.
Purpose of the Study:
- To evaluate the contribution of thrombus formation to unstable angina pathogenesis.
- To assess the activation of various components of the hemostatic system in unstable angina patients.
- To compare hemostatic markers in unstable angina patients with healthy controls.
Main Methods:
- Hemostatic measurements were performed in 47 unstable angina patients over 5 days.
- Assays measured small fragments reflecting activation of hemostatic system components.
- Results were compared against healthy control values.
Main Results:
- Patients showed elevated fibrinogen, factor VIII:C, von Willebrand factor, fibrinopeptide A, and thrombin-antithrombin complexes, indicating thrombin generation.
- Markedly elevated platelet release proteins (beta-thromboglobulin and platelet factor 4) were observed in the initial 2 days.
- Elevated plasminogen activator inhibitor (PAI) suggested fibrinolysis inhibition, while ATIII was lower and APTT/TT prolonged.
- PT and reptilase time were unaffected, consistent with heparinization.
Conclusions:
- Patients with unstable angina exhibit significant activation of the clotting system.
- There is evidence of inhibited fibrinolysis in unstable angina patients.
- These findings confirm a pro-thrombotic tendency in the pathogenesis of unstable angina.