Kok M G M, Meijers J C M, Pinto-Sietsma S-J
Dr. Sara-Joan Pinto-Sietsma, MD, PhD,, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Postbus 22660, Amsterdam 1100 DD, The Netherlands, E-mail:
Thromb Haemost. 2014 Mar 3;111(3):458-64. doi: 10.1160/TH13-07-0587. Epub 2013 Dec 5.
The relation between coagulation and atherosclerosis has been extensively described, pointing towards a hypercoagulable state in patients with atherosclerosis, especially in young individuals. However, not all studies were conclusive. It is known that the metabolic syndrome (MetS), a risk factor for coronary artery disease (CAD), is related to a higher incidence of thrombo-embolic events. We hypothesised that individuals with CAD at a young age and MetS have an increased prothrombotic potential. It was the study objective to analyse the endogenous thrombin potential (ETP) and related thrombin generation parameters in patients with CAD before the age of 51 in men and 56 in women with and without MetS features and their healthy first-degree relatives. In this case-control study we included 118 CAD patients and 50 first-degree relatives (controls). Parameters of thrombin generation were obtained with calibrated automated thrombinography. An adjusted general linear model (GLM) showed a positive association between the peak thrombin levels and the presence of CAD at a young age. Based on the NCEP criteria we divided our patient group in CAD patients with and without MetS, and compared them to the controls without MetS. We showed that CAD patients with MetS have increased ETP levels, both in comparison with healthy first-degree relatives and with CAD patients without MetS. There were no differences in ETP between patients without MetS and healthy controls. In conclusion, this study shows that individuals with CAD at a young age and MetS features have an increased prothrombotic potential, compared to CAD patients without MetS.
凝血与动脉粥样硬化之间的关系已被广泛描述，表明动脉粥样硬化患者存在高凝状态，尤其是在年轻人中。然而，并非所有研究都得出了确凿结论。已知代谢综合征（MetS）作为冠状动脉疾病（CAD）的一个危险因素，与血栓栓塞事件的较高发生率相关。我们假设年轻的CAD患者合并MetS具有更高的血栓形成潜力。本研究的目的是分析年龄在51岁以下男性和56岁以下女性的CAD患者中，有无MetS特征及其健康的一级亲属的内源性凝血酶潜力（ETP）和相关凝血酶生成参数。在这项病例对照研究中，我们纳入了118例CAD患者和50名一级亲属（对照组）。采用校准自动凝血酶生成法获得凝血酶生成参数。调整后的一般线性模型（GLM）显示，凝血酶峰值水平与年轻时患CAD之间存在正相关。根据美国国家胆固醇教育计划（NCEP）标准，我们将患者组分为有和无MetS的CAD患者，并将他们与无MetS的对照组进行比较。我们发现，与健康的一级亲属以及无MetS的CAD患者相比，合并MetS的CAD患者ETP水平升高。无MetS的患者与健康对照组之间的ETP没有差异。总之，本研究表明，与无MetS的CAD患者相比，年轻的CAD患者合并MetS具有更高的血栓形成潜力。
