Orem Cihan, Celik Sükrü, Orem Asim, Calapoğlu Mustafa, Erdöl Cevdet
Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
Thromb Res. 2002 Jan 1;105(1):37-41. doi: 10.1016/s0049-3848(01)00414-5.
Fibronectin is a polymorphic and multifunctional glycoprotein that plays a wide-ranging role in hemostasis. In this study, it was aimed to determine plasma fibronectin levels and evaluate its possible role in left ventricular (LV) thrombus formation following acute myocardial infarction (AMI). We have determined clinical, echocardiographic, and biochemical parameters in 97 consecutive patients (aged 59 +/- 13; 87 men/10 women) with first anterior AMI. Two-dimensional echocardiography was performed on Days 1, 3, 7, 15, and 30. Blood samples were obtained within 24-48 h after the onset of symptoms. The study also included 30 healthy control subjects. Plasma fibronectin levels were significantly higher in patients with AMI than control subjects (38 +/- 13 vs. 25.2 +/- 8.7 mg/dl, P=.0001). LV thrombus was detected in 20 (20.6%) of 97 patients. Plasma fibronectin levels were significantly higher in patients with LV thrombus (Group 2) than in patients without LV thrombus (Group 1) (44.5 +/- 11 vs. 36.1 +/-13.4 mg/dl, P=.01). Although univariate analysis showed that plasma fibronectin levels were higher in patients with thrombus, multivariate analysis showed that plasma fibronectin levels were not an independent predictor of LV thrombus formation (P=.059). In multivariate analyses, only peak creatine phosphokinase (CPK) level and LV wall motion score index (WMSI) were independent predictors of thrombus formation (P=.007 and P=.0001, respectively). These results suggest the increased plasma fibronectin levels may be one of the risk factors for LV thrombus formation after AMI. However, further studies concerning the relation between plasma fibronectin levels and LV thrombus formation are necessary.
纤连蛋白是一种多态性多功能糖蛋白，在止血过程中发挥着广泛作用。本研究旨在测定血浆纤连蛋白水平，并评估其在急性心肌梗死（AMI）后左心室（LV）血栓形成中的可能作用。我们测定了97例连续的首次前壁AMI患者（年龄59±13岁；87例男性/10例女性）的临床、超声心动图和生化参数。在第1、3、7、15和30天进行二维超声心动图检查。症状发作后24 - 48小时内采集血样。该研究还纳入了30名健康对照者。AMI患者的血浆纤连蛋白水平显著高于对照者（38±13 vs. 25.2±8.7 mg/dl，P = 0.0001）。97例患者中有20例（20.6%）检测到LV血栓。有LV血栓的患者（第2组）血浆纤连蛋白水平显著高于无LV血栓的患者（第1组）（44.5±11 vs. 36.1±13.4 mg/dl，P = 0.01）。虽然单因素分析显示有血栓的患者血浆纤连蛋白水平较高，但多因素分析显示血浆纤连蛋白水平不是LV血栓形成的独立预测因素（P = 0.059）。在多因素分析中，只有肌酸磷酸激酶（CPK）峰值水平和LV壁运动评分指数（WMSI）是血栓形成的独立预测因素（分别为P = 0.007和P = 0.0001）。这些结果表明，血浆纤连蛋白水平升高可能是AMI后LV血栓形成的危险因素之一。然而，有必要进一步研究血浆纤连蛋白水平与LV血栓形成之间的关系。
