Markers of Thrombosis and Hemostasis in Acute Coronary Syndromes: Relationship to Increased Heart Rate and Reduced Heart‐Rate Variability

Abstract

Background: Acute coronary syndromes (ACS) are characterized by abnormal heart-rate variability (HRV) and biomarkers of endothelial damage and thrombosis. Hypothesis: We hypothesized an association between these factors in patients with ACS. Methods: We studied 99 patients with ACS measuring HRV and plasma markers of endothelial damage/dysfunction (von Willebrand factor, vWF) and thrombosis/hemostasis (soluble P-selectin (s-Psel); CD 40 -ligand (CD 40 -L); D-dimer). HRV and plasma indices were compared to age-and gender-matched controls. Measures were repeated at 4 months in a subset. vWF, s-Psel and D-Dimer levels were raised compared to control. Results: HRV indices were reduced (mean RR, SDNN, SDNNi, RMSSD, Triangular index, LF and HF). There were weak correlations between mean RR and s-Psel (R = −0.234, p = 0.023) and D-dimer (R = −0.219, p = 0.041). At 4-month follow-up, significant correlations were between mean RR and CD 40 L (R = −0.414, p = 0.008) and D-dimer (R = −0.363, p = 0.012). On multivariate logistic regression analysis statin use (p = 0.046) was the only independent predictor of acute s-Psel levels. Age (p = 0.004) and mean RR interval (p = 0.01) were independent predictors of D-dimer levels at follow-up. Conclusions: Abnormal HRV is associated with markers of hemostasis and thrombosis in ACS, and present both in the acute and rehabilitation phases.

Correlation of von Willebrand factor gene polymorphism and coronary heart disease

“…The plasma vWF levels of two genotypes (AG and GG) in the experimental group were higher than their corresponding levels in the control group. The results may be associated with a higher risk of vascular endothelial injury in patients with coronary heart disease, resulting in more vWF being released by the endothelial cells into the plasma (13).…”

Resilience to orthostasis and haemorrhage: A pilot study of common genetic and conditioning mechanisms

“…Other studies have investigated the relationship between CV activity and haemostatic variables in patients. For example, a recent study observed a lower resting heart rate variability in patients with acute coronary syndrome who also showed increased levels of von Willebrand factor, soluble P-selectin and D-dimer compared to healthy subjects, but did not detect correlations between different indexes of heart rate variability and these thrombotic/haemostatic markers 26 . Other studies have found that the power of a high frequency component of heart rate variability (HF-HRV) obtained during 24-hour monitoring was inversely associated with both a composite prothrombotic index and individual levels of haemostatic factors, including von Willebrand factor antigen (VWF:Ag), activated clotting factor VII, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and mean platelet volume (MPV) 27 28 .…”

Viral Serpin Therapeutics

“…15.8, separated by placebo, serpin treatment and dosage, and time to follow-up. DD has been correlated with inflammatory, unstable coronary syndromes (ACS), as well as with pulmonary emboli (Empana et al ., 2008; Hamaad et al ., 2009) and is a by-product of fibrin degradation (fibrinolysis), the pathways targeted in part by the serpin treatment.…”