Sotoudeh Anvari Maryam, Tavakoli Mojgan, Lotfi-Tokaldany Masoumeh, Broumand Mohammadali, Rezahosseini Omid, Hakki-Kazzazi Elham, Jalali Arash
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2018 Jan;13(1):1-5.
Standard coagulation screening tests are important constituents of basic examinations in clinical laboratories. There is no clear evidence of a relation between the type of clinical presentation and coagulation parameters in patients with suspected coronary artery disease. This cross-sectional study included 539 patients who underwent coronary angiography in Tehran Heart Center between November 2012 and January 2013. Patients presented with ST-segment-elevation myocardial infarction (STEMI), non-STEMI, unstable angina, or stable angina. Prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were measured before angiography and compared between the clinical presentation groups. The mean age of the patients was 59.156 ± 11.05 years, and 47.7% were male. STEMI was reported in 41(7.6%) patients, non-STEMI in 42 (7.8%), unstable angina in 304 (56.4%), and stable angina in 152 (28.2%). No difference in the mean PT and INR was found between the groups. The mean APTT was significantly lower among the patients presenting with STEMI and non-STEMI (26.58 ± 2.32 s in the STEMI, 26.85 ± 2.41 s in the non-STEMI, 27.64 ± 2.54 s in the unstable, and 27.93 ± 2.53 s in the stable angina groups, respectively, p value = 0.005). After adjustment, the association between the patients' presentations and APTT was significant (OR for 5 s increase in APTT = 1.661, 95% CI = 1.184 to 2.332; p value = 0.003). We observed that the patients who presented with STEMI had the lowest value of APTT, whereas those who presented with stable angina had the highest. The value of APTT in patients undergoing coronary angiography may have a potential to predict the extent and severity of coronary stenosis.
标准凝血筛查试验是临床实验室基础检查的重要组成部分。在疑似冠心病患者中,临床表现类型与凝血参数之间尚无明确的关联证据。这项横断面研究纳入了2012年11月至2013年1月期间在德黑兰心脏中心接受冠状动脉造影的539例患者。患者表现为ST段抬高型心肌梗死(STEMI)、非STEMI、不稳定型心绞痛或稳定型心绞痛。在血管造影术前测量凝血酶原时间(PT)、国际标准化比值(INR)和活化部分凝血活酶时间(APTT),并在各临床表现组之间进行比较。患者的平均年龄为59.156±11.05岁,47.7%为男性。41例(7.6%)患者报告为STEMI,42例(7.8%)为非STEMI,304例(56.4%)为不稳定型心绞痛,152例(28.2%)为稳定型心绞痛。各组之间的平均PT和INR未发现差异。STEMI和非STEMI患者的平均APTT显著较低(STEMI组为26.58±2.32秒,非STEMI组为26.85±2.41秒,不稳定型心绞痛组为27.64±2.54秒,稳定型心绞痛组为27.93±2.53秒,p值=0.005)。调整后,患者表现与APTT之间的关联具有显著性(APTT增加5秒的OR=1.661,95%CI=1.184至2.332;p值=0.003)。我们观察到,表现为STEMI的患者APTT值最低,而表现为稳定型心绞痛的患者APTT值最高。接受冠状动脉造影患者的APTT值可能具有预测冠状动脉狭窄程度和严重性的潜力。