Activated and Total Coagulation Factor VII, and Fibrinogen in Coronary Artery Disease

Abstract

Fibrinogen (FBG) and total coagulation factor VII (FVIIc) concentrations are higher in those patients with coronary artery disease who are at increased future risk of acute ischemic events. The relationship between activated factor VII (FVIIa) and cardiovascular events, however, has not been intensively studied. Data were collected from 401 consecutive patients who underwent coronary angiography because of suspected coronary artery disease. Conventional risk factors FVIIc, FVIIa and FBG were assessed in relation to the severity of coronary artery disease, left ventricular ejection fraction, and previous clinical events. A strong positive correlation was found between FVIIa and FVIIc (p < 0.001), but neither FVIIa nor FVIIc correlated with FBG. No correlation was found between FVIIa, FVIIc or FBG levels and stenosis score for the severity of coronary artery disease, and all were similar in patients with stable or unstable angina pectoris. Multivariate regression analysis showed FVIIc to be higher in women (p = 0.004), and positively related to triglycerides (p = 0.001) and HDL cholesterol (p = 0.006), but not to a previous myocardial infarction or total cholesterol. FVIIa, on the other hand, was lower in patients with a previous myocardial infarction (p = 0.004), higher in women (p = 0.001) and those that previously had undergone percutaneous transluminal coronary angioplasty (p = 0.039), and positively related to total cholesterol (p = 0.011), duration of coronary artery disease (p = 0.032), and smoking (p = 0.008). FBG was positively associated with a previous myocardial infarction (p = 0.013), hypertension (p = 0.016), smoking (p = 0.005), and the thrombocyte count (p < 0.001). Finally, stepwise logistic regression analysis verified a previous myocardial infarction to be negatively associated with FVIIa (p = 0.03), and positively with FBG (p = 0.03), total cholesterol (p = 0.02), and the severity of coronary artery disease (p < 0.001). In conclusion, in patients suspected of coronary artery disease undergoing cardiac catheterization, FVIIa was decreased and FBG increased in those who had a previous myocardial infarction. FVIIa, FVIIc, or FBG levels were not, however, related to the severity of coronary artery disease, and they were similar in patients with stable or unstable angina pectoris.

Blood Coagulation and Fibrinolytic Activity in Hypothyroidism

“…FVIIa may play an important role in a hypercoagulable state 23 . Increased FVII has been shown to be a risk factor for coronary heart disease 24 . In our study, we found a decrease in factor VIII and X activity.…”

“…23 Increased FVII has been shown to be a risk factor for coronary heart disease. 24 In our study, we found a decrease in factor VIII and X activity. VWF and FVII activity did not change in hypothyroid patients.…”

How it all starts: Initiation of the clotting cascade

“…Population studies have reported that fVII levels are unrelated to the degree of carotid artery thickness or other manifestations of vascular disease (Folsom et al ., 1993; Koster et al ., 1994; Moor et al ., 1995; Sosef et al ., 1994; Vaziri et al ., 1992). Results have been mixed with regard to a potential correlation between fVIIa levels and the risk of thrombotic disease (Kalaria et al ., 2000) (Danielsen et al ., 1998; Cooper et al ., 2000). …”

Serum Levels of Vitamin D and Haemostatic Factors in Healthy Subjects: The Tromsø Study

“…F1+2 formed by the transformation of prothrombin to thrombin and serving as a marker of ongoing coagulation [29], FVIIa which together with tissue factor initiates the coagulation cascade through the extrinsic pathway and, if elevated, may reflect a hypercoagulable state [9], and FVIIc which has been associated with an increased risk of coronary events [30, 23] – we found no significant relation to the vitamin D levels nor did we find any other studies where this was evaluated.…”