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Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia
Thrombus formation and myocardial infarction are not uncommon in patients with coronary artery ectasia (CAE). In light of this, the present study aims to systemically evaluate the blood coagulation and fibrinolytic systems in CAE patients. In this study, we enrolled 30 patients with CAE, 30 patients...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779002/ https://www.ncbi.nlm.nih.gov/pubmed/26937905 http://dx.doi.org/10.1097/MD.0000000000002779 |
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author | Wu, Wei Liu, Ruifeng Chen, Lianfeng Chen, Houzao Zhang, Shuyang |
author_facet | Wu, Wei Liu, Ruifeng Chen, Lianfeng Chen, Houzao Zhang, Shuyang |
author_sort | Wu, Wei |
collection | PubMed |
description | Thrombus formation and myocardial infarction are not uncommon in patients with coronary artery ectasia (CAE). In light of this, the present study aims to systemically evaluate the blood coagulation and fibrinolytic systems in CAE patients. In this study, we enrolled 30 patients with CAE, 30 patients with coronary atherosclerosis disease (CAD), and 29 subjects with normal coronary arteries (control). The coagulation system was evaluated using a routine coagulation function test performed in the hospital laboratory before coronary angiography, and measurements included prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen time, and thrombin time. The evaluation of the fibrinolytic system included measurements of D-dimer, euglobulin lysis time, plasminogen activator inhibitor 1, plasminogen, plasminogen activity assay, α1-antitrypsin (α1-AT), α2 plasmin inhibitor (α2-PI), and α2-macroglobulin (α2-MG). Alpha1-AT, α2-PI, and α2-MG also inhibit activities of 3 neutrophil serine proteases, namely human neutrophil elastase (HNE), cathepsin G (CG), and proteinase 3 (PR3); therefore, the plasma levels of these 3 proteinases were also evaluated. In CAE patients, the circulating coagulation system was normal. For the fibrinolytic system, a decrease of plasminogen activity was observed (P = 0.029) when compared with CAD patients, and the concentrations of α1-AT (both P < 0.001), α2-PI (P = 0.002 and P = 0.025), and α2-MG (P = 0.034 and P < 0.001) were significantly elevated when compared with CAD patients and normal controls. Moreover, the plasma levels of HNE (both P < 0.001) and CG (P = 0.027 and 0.016) in CAE patients were also significantly higher than those of the CAD and control groups. There was no difference in plasma PR3 concentration among these 3 groups. Disequilibrium of the coagulation/fibrinolytic system may contribute to thrombus formation and clinical coronary events in patients with CAE. The increased plasma concentrations of α1-AT, α2-PI, and α2-MG might provide beneficial effects by inhibiting the proteinases and restraining the ectatic process; on other hand, they led to unfavorable results by inhibiting plasmin and decreasing thrombus degradation in CAE patients. |
format | Online Article Text |
id | pubmed-4779002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-47790022016-03-24 Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia Wu, Wei Liu, Ruifeng Chen, Lianfeng Chen, Houzao Zhang, Shuyang Medicine (Baltimore) 3400 Thrombus formation and myocardial infarction are not uncommon in patients with coronary artery ectasia (CAE). In light of this, the present study aims to systemically evaluate the blood coagulation and fibrinolytic systems in CAE patients. In this study, we enrolled 30 patients with CAE, 30 patients with coronary atherosclerosis disease (CAD), and 29 subjects with normal coronary arteries (control). The coagulation system was evaluated using a routine coagulation function test performed in the hospital laboratory before coronary angiography, and measurements included prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen time, and thrombin time. The evaluation of the fibrinolytic system included measurements of D-dimer, euglobulin lysis time, plasminogen activator inhibitor 1, plasminogen, plasminogen activity assay, α1-antitrypsin (α1-AT), α2 plasmin inhibitor (α2-PI), and α2-macroglobulin (α2-MG). Alpha1-AT, α2-PI, and α2-MG also inhibit activities of 3 neutrophil serine proteases, namely human neutrophil elastase (HNE), cathepsin G (CG), and proteinase 3 (PR3); therefore, the plasma levels of these 3 proteinases were also evaluated. In CAE patients, the circulating coagulation system was normal. For the fibrinolytic system, a decrease of plasminogen activity was observed (P = 0.029) when compared with CAD patients, and the concentrations of α1-AT (both P < 0.001), α2-PI (P = 0.002 and P = 0.025), and α2-MG (P = 0.034 and P < 0.001) were significantly elevated when compared with CAD patients and normal controls. Moreover, the plasma levels of HNE (both P < 0.001) and CG (P = 0.027 and 0.016) in CAE patients were also significantly higher than those of the CAD and control groups. There was no difference in plasma PR3 concentration among these 3 groups. Disequilibrium of the coagulation/fibrinolytic system may contribute to thrombus formation and clinical coronary events in patients with CAE. The increased plasma concentrations of α1-AT, α2-PI, and α2-MG might provide beneficial effects by inhibiting the proteinases and restraining the ectatic process; on other hand, they led to unfavorable results by inhibiting plasmin and decreasing thrombus degradation in CAE patients. Wolters Kluwer Health 2016-03-03 /pmc/articles/PMC4779002/ /pubmed/26937905 http://dx.doi.org/10.1097/MD.0000000000002779 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 3400 Wu, Wei Liu, Ruifeng Chen, Lianfeng Chen, Houzao Zhang, Shuyang Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia |
title | Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia |
title_full | Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia |
title_fullStr | Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia |
title_full_unstemmed | Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia |
title_short | Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia |
title_sort | disequilibrium of blood coagulation and fibrinolytic system in patients with coronary artery ectasia |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779002/ https://www.ncbi.nlm.nih.gov/pubmed/26937905 http://dx.doi.org/10.1097/MD.0000000000002779 |
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