Usefulness of single fibrinopeptide A determination in patients with acute ischemic coronary artery syndromes.

Coronary artery thrombosis plays a major role in the acute ischemic coronary artery syndromes in which fibrinopeptide A (FPA) has proved to be a sensitive marker. The purpose of this study was to determine FPA concentrations in patients with acute coronary artery syndromes and to determine if these could serve as a short-term prognostic indicator. Single plasma FPA levels were measured in 26 patients with acute ischemic coronary artery syndromes within 24 hours of the onset of chest pain as well as in 12 patients with chronic stable angina and in 9 control subjects. Higher FPA levels were observed in patients with unstable angina whom later developed recurrence of chest pain compared to those without (8.1 +/- 3.4 vs. 3.4 +/- 2.2; p = 0.01). Neither the localization of ischemia, presence of complications, need for revascularization nor short-term prognosis (6 months) correlated with the plasma FPA concentration. Therefore, except for recurrence of chest pain in patients with unstable angina, the finding of an elevated FPA level upon admission did not provide additional information regarding clinical course and prognosis than that obtained in a detailed clinical history, physical examination and initial electrocardiogram in patients with acute ischemic artery syndromes.