Abdulah, Wan Zaidah
(2011)
A comparative study on haemostatic markers and prothrombotic genes among patients with acute
coronary syndrome and stable coronary heart disease.
A comparative study on haemostatic markers and prothrombotic genes among patients with acute coronary syndrome and stable coronary heart disease..
Abstract
Background: Stable corornuy artery disease (SCAD) and acute corornuy
syndrome (ACS) are expected to be biologically different in their
prothrombotic activities. Objectives: The aims of this study were to
investigate the association of haemostatic markers, prothrombotic genes and
clinical factors between ACS and SCAD. Methodology: A comparative
prospective cross sectional study was done at Hospital Universiti Sains
Malaysia (HUSM), involving 110 ACS and 55 SCAD patients. Full blood
count (FBC), Prothrombin time (PT), activated partial prothrombin time
(APTT), fibrinogen level, FVIII assay, von Willebrand factor antigen
(vWF:Ag), activated protein C resistance (APC-R) assay and protein Z level
(PZ) were performed on all samples. Analysis of a few prothrombotic genes
involving methylene tetrahydrofolate reductase (MlHFR), factor V Leiden
(FVL) gene mutations, plasminogen activator inhibitor-I (PAI-1) and human
platelet antigen (HP A) I a-1 b polymorphisms were done. Results: A total of
165 CHD patients, 129 males and 36 females were recruited. The mean age of
the patients was 60.05 years. FVIII, vWF:Ag and fibrinogen levels were
significantly increased in ACS group compared to SCAD group ( p-value <
0.0001, < 0.0001 and 0.005 respectively). APTT was significantly shortened in
ACS group compared to SCAD group (p-value < 0.0001). Most of the patients
had at least one traditional risk factor for CHD. From multiple logistic
regression, factors associated with ACS include high vWF:Ag, high FVIII, 2: 2
prothrombotic genes and histoiy of smoking. Sixty two percent of patients
were on aspirin during ACS event. Discussion and conclusion: The
prothrombotic activities were shown to be enhanced in ACS group.
Haemostatic stress factors combined with multiple prothrombotic genes and
histoiy of smoking were found to be associated with ACS in this study. These
findings explained the different prothrombotic activities seen in SCAD and
ACS and the potential of added morbidity during ACS event. In future,
prothrombotic biomarkers may be used as predictors for ACS among the
SCAD patients. The possibility of aspirin resistance state among these patients
should be addressed.
Actions (login required)
 |
View Item |
