Abstract 20153: Role of Tissue Factor Activity, Tissue Factor Antigen and Tissue Factor Pathway Inhibitor in ST-Elevation Myocardial Infarction Undergoing Primary Angioplasty
Tissue factor contributes to thrombosis following plaque disruption in acute coronary syndromes. This study was designed to assess: 1) the role of circulating tissue factor activity (TF a), tissue factor antigen (Ag TF) and tissue factor pathway inhibitor antigen (Ag TFPI) levels, and 2) the relationship between TF a, Ag TF, Ag TFPI plasma levels and classical markers of myocardial damage in patients with a first ST-elevated myocardial infarction (STEMI) receiving a primary percutaneous coronary intervention (PCI).
Methods and results: The plasma TFa, Ag TF and Ag TFPI levels were determined in plasma samples taken from 95 patients (77 m/ 18 f; age 61.2±12.8 years) with a first STEMI with TIMI 0, before to open the culprit artery, at discharge, one month and at 6 months after discharge. Mean of clinical follow-up was 1.5±1 years. Those markers were also determined in 95 healthy donors matched by sex and age free from cardiovascular factors risk. Patients with STEMI showed a higher circulating Ag TF and Ag TFPI levels while TFa was lower than in healthy donors. At admission, TFa was lower and Ag TFPI higher than those determinations at discharge, 1 and 6 months. However, Ag TF levels were similar at discharge and decreased significantly at 1 and 6 months (Table 1). There was a good correlation between TFa, AgTF and AgTFPI. AgTFPI ≥50th percentile (≥343.15 ng/ml) plasma levels at admission were associated with a significant higher levels of CKMB mass (p=0.04) and troponin (p=0.01).
Conclusions: Our results demonstrated that plasma TFa levels are low and AgTFPI elevated in patients with STEMI before to open the culprit artery. Patients with STEMI and heightened AgTFPI levels are at risk for an increased myocardial damage. Table 1. (*) denotes: p<0.01. Values are referred to differences between plasma admission levels.
- © 2010 by American Heart Association, Inc.