Circulation, Vol 75, 156-162, Copyright © 1987 by American Heart Association
P Theroux, JG Latour, C Leger-Gauthier and J De Lara
Fibrinopeptide A, platelet factor 4, beta-thromboglobulin, thromboxane B2,
and 6-keto-prostaglandin F1 alpha were estimated by radioimmunoassay on
venous plasma samples taken within 48 hr of admission from 16 consecutive
patients with unstable angina and 15 patients with stable angina matched
for clinical variables. The ratio of circulating platelet aggregates,
platelet aggregation to increasing concentrations of ADP (0.455 to 1.82
micrograms/ml), and platelet thromboxane B2 production in vitro were also
tested. The two groups of patients were statistically similar in terms of
sex distribution, age, presence of risk factors, use of medication, extent
of coronary artery disease and history of previous myocardial infarction.
Mean plasma levels of fibrinopeptide A were 2.7 +/- 0.4 ng/ml (geometric
means +/- SEM, range 1.5 to 5.5) in patients with stable angina vs 5.5 +/-
1.8 ng/ml (range 2.4 to 32; p less than .001) in those with unstable
angina. In the latter group, after 6 to 8 days, fibrinopeptide A levels
decreased to 3.6 +/- 0.5 ng/ml (range 1.5 to 9.3; p less than .04 vs
admission). All other variables measured were statistically identical in
the two groups. We conclude that plasma fibrinopeptide A levels, as opposed
to platelet factors, discriminate between patients with unstable and stable
angina, indicating an activation of the coagulation system in unstable
angina.
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Fibrinopeptide A and platelet factor levels in unstable angina pectoris
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