Wilensky R L, Zeller J A, Wish M, Tulchinsky M
Medical Service, Veterans Administration Medical Center, Washington, D.C.
J Am Coll Cardiol. 1989 Sep;14(3):597-603. doi: 10.1016/0735-1097(89)90099-5.
Because acute coronary thrombosis can cause unstable coronary artery disease, fibrinopeptide A, a reliable marker of coagulation activity, may play a role in the evaluation of unstable ischemic syndromes. A new method of fibrinopeptide A sampling, spot urine normalized to urinary creatinine, was evaluated in patients with stable and unstable angina pectoris and acute myocardial infarction. Serial samples were obtained to characterize the changes in urinary fibrinopeptide A levels over time in patients with ischemic heart disease. Admission values (mean +/- SD) were similar in the control group (3.3 +/- 1.4 ng/mg creatinine) and the stable angina group (3.2 +/- 1.1 ng/mg creatinine) (p = NS). Values in the unstable angina group (5.7 +/- 2.6 ng/mg creatinine) were higher than those in the control (p = 0.008) and stable angina (p less than 0.001) groups. Myocardial infarction admission values (8.4 +/- 10.0 ng/mg creatinine) were higher than those in the control (p = 0.005) and stable angina (p less than 0.001) groups, but not higher than those in the unstable angina group. Peak values (the highest of multiple samples) were higher in the unstable angina group (7.6 +/- 5.9 ng/mg creatinine) than in the stable angina group (4.0 +/- 1.0 ng/mg creatinine) (p = 0.04), but not in the control group (4.5 +/- 1.9 ng/mg creatinine) (p = 0.056). The two patients with unstable angina with the highest peak values subsequently exhibited infarction. Peak values in patients with infarction (44.5 +/- 60.0 ng/mg creatinine) were significantly higher than those in patients with unstable (p = 0.03) or stable (p = 0.002) angina and control patients (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
由于急性冠状动脉血栓形成可导致不稳定型冠状动脉疾病，纤维蛋白肽A作为凝血活性的可靠标志物，可能在不稳定型缺血综合征的评估中发挥作用。我们对一种新的纤维蛋白肽A采样方法（即尿肌酐标准化的即时尿样）在稳定型和不稳定型心绞痛以及急性心肌梗死患者中进行了评估。采集系列样本以描述缺血性心脏病患者尿纤维蛋白肽A水平随时间的变化。对照组（3.3±1.4 ng/mg肌酐）和稳定型心绞痛组（3.2±1.1 ng/mg肌酐）的入院值（均值±标准差）相似（p=无显著性差异）。不稳定型心绞痛组的值（5.7±2.6 ng/mg肌酐）高于对照组（p=0.008）和稳定型心绞痛组（p<0.001）。心肌梗死入院值（8.4±10.0 ng/mg肌酐）高于对照组（p=0.005）和稳定型心绞痛组（p<0.001），但不高于不稳定型心绞痛组。不稳定型心绞痛组的峰值（多个样本中的最高值）（7.6±- 5.9 ng/mg肌酐）高于稳定型心绞痛组（4.0±1.0 ng/mg肌酐）（p=0.04），但在对照组（4.5±1.9 ng/mg肌酐）中无差异（p=0.056）。峰值最高的两名不稳定型心绞痛患者随后发生了梗死。梗死患者的峰值（44.5±60.0 ng/mg肌酐）显著高于不稳定型（p=0.03）或稳定型（p=0.002）心绞痛患者及对照组患者（p<0.001）。（摘要截短于250字）
