Plasma thrombomodulin activity, tissue factor activity and high levels of circulating procoagulant phospholipid as prognostic factors for acute myocardial infarction

Abstract

Several studies have indicated an association between haemostatic markers and acute myocardial infarction, but few or no studies refer to their activity. We studied plasma levels of 10 coagulation factors (fibrinogen, protein C, protein S, von Willebrand factor, D-dimers, factor VIIa, free tissue factor pathway inhibitor, tissue-type plasminogen activator, plasminogen activator inhibitor-1, thrombomodulin) and using new specific assays analysed the activity of plasma tissue factor (TFa), thrombomodulin (TMa), and procoagulant phospholipid in 46 consecutive patients with acute myocardial infarction at the time of hospital admission, and compared them with 34 healthy normal volunteers. Plasma levels of TFa, TMa, and procoagulant phospholipid were significantly higher in cases than in control patients (P < 0.001). In addition the ratio of TFa/free tissue factor pathway inhibitor was higher in patients than in controls, whereas the tissue-type plasminogen activator (t-PA)/plasminogen activator inhibitor-1 ratio was lower in patients. Interestingly, patients with an unfavourable outcome during a 2-month follow-up had higher levels of TFa, TMa, procoagulant phospholipid, a higher ratio of TFa/free tissue factor pathway inhibitor and a lower ratio of t-PA/plasminogen activator inhibitor-1 than patients who recovered. The combination of these different parameters reveals an increase in procoagulant activity as well as impaired fibrinolytic activity during the acute phase of an acute myocardial infarction. The association of the level of the activity of these three factors may provide a new tool to assess the prognosis of acute myocardial infarction. Further studies are needed to support our findings and to elucidate the clinical interest of measuring these factors.

Nontraditional Risk Factors and Biomarkers for Cardiovascular Disease: Mechanistic, Research, and Clinical Considerations for Youth

“…Elevated plasma PAI-1 activity, PAI-1 antigen, and tPA antigen are associated with an increased risk of MI. 244 The increased plasma PAI-1 antigen concentrations reported in the obese subjects are accompanied by increased plasma tPA antigen. A lowered fibrinolytic state and increased plasma PAI-1 activity have both been shown to be independently associated with increased risk of future coronary heart disease events or recurrent events, respectively.…”

HMGB1 and thrombin mediate the blood-brain barrier dysfunction acting as biomarkers of neuroinflammation and progression to neurodegeneration in Alzheimer’s disease

“…Soluble thrombomodulin (sTM) antigen (TMa) levels were assayed by kit (Stago, Gennevilliers, France), and sTM activity was measured as described previously [33]. …”

Impact of blood hypercoagulability on in vitro fertilization outcomes: a prospective longitudinal observational study

“…Tissue Factor activity (TFa) in PPP was measured with a clotting-based assay as previously described [20, 21]. The inter- and intra-assay coefficients of variation were 7% and 5% respectively.…”