Danielsen R, Onundarson P T, Thors H, Vidarsson B, Morrissey J H
Department of Medicine, Landspítalinn, University Hospital, Reykjavik, Iceland.
Scand Cardiovasc J. 1998;32(2):87-95. doi: 10.1080/14017439850140238.
Fibrinogen (FBG) and total coagulation factor VII (FVIIc) concentrations are higher in those patients with coronary artery disease who are at increased future risk of acute ischemic events. The relationship between activated factor VII (FVIIa) and cardiovascular events, however, has not been intensively studied. Data were collected from 401 consecutive patients who underwent coronary angiography because of suspected coronary artery disease. Conventional risk factors FVIIc, FVIIa and FBG were assessed in relation to the severity of coronary artery disease, left ventricular ejection fraction, and previous clinical events. A strong positive correlation was found between FVIIa and FVIIc (p < 0.001), but neither FVIIa nor FVIIc correlated with FBG. No correlation was found between FVIIa, FVIIc or FBG levels and stenosis score for the severity of coronary artery disease, and all were similar in patients with stable or unstable angina pectoris. Multivariate regression analysis showed FVIIc to be higher in women (p = 0.004), and positively related to triglycerides (p = 0.001) and HDL cholesterol (p = 0.006), but not to a previous myocardial infarction or total cholesterol. FVIIa, on the other hand, was lower in patients with a previous myocardial infarction (p = 0.004), higher in women (p = 0.001) and those that previously had undergone percutaneous transluminal coronary angioplasty (p = 0.039), and positively related to total cholesterol (p = 0.011), duration of coronary artery disease (p = 0.032), and smoking (p = 0.008). FBG was positively associated with a previous myocardial infarction (p = 0.013), hypertension (p = 0.016), smoking (p = 0.005), and the thrombocyte count (p < 0.001). Finally, stepwise logistic regression analysis verified a previous myocardial infarction to be negatively associated with FVIIa (p = 0.03), and positively with FBG (p = 0.03), total cholesterol (p = 0.02), and the severity of coronary artery disease (p < 0.001). In conclusion, in patients suspected of coronary artery disease undergoing cardiac catheterization, FVIIa was decreased and FBG increased in those who had a previous myocardial infarction. FVIIa, FVIIc, or FBG levels were not, however, related to the severity of coronary artery disease, and they were similar in patients with stable or unstable angina pectoris.
在那些未来发生急性缺血事件风险增加的冠心病患者中，纤维蛋白原（FBG）和总凝血因子VII（FVIIc）浓度较高。然而，活化因子VII（FVIIa）与心血管事件之间的关系尚未得到深入研究。数据收集自401例因疑似冠心病接受冠状动脉造影的连续患者。评估了传统危险因素FVIIc、FVIIa和FBG与冠状动脉疾病严重程度、左心室射血分数及既往临床事件的关系。发现FVIIa与FVIIc之间存在强正相关（p < 0.001），但FVIIa和FVIIc与FBG均无相关性。未发现FVIIa、FVIIc或FBG水平与冠状动脉疾病严重程度的狭窄评分之间存在相关性，且在稳定型或不稳定型心绞痛患者中所有这些指标均相似。多因素回归分析显示，女性的FVIIc较高（p = 0.004），且与甘油三酯（p = 0.001）和高密度脂蛋白胆固醇（p = 0.006）呈正相关，但与既往心肌梗死或总胆固醇无关。另一方面，既往有心肌梗死的患者FVIIa较低（p = 0.004），女性及既往接受过经皮腔内冠状动脉成形术的患者FVIIa较高（p = 0.039），且FVIIa与总胆固醇（p = 0.011）、冠状动脉疾病病程（p = 0.032）及吸烟（p = 0.008）呈正相关。FBG与既往心肌梗死（p = 0.013）、高血压（p = 0.016）、吸烟（p = 0.005）及血小板计数（p < 0.001）呈正相关。最后，逐步逻辑回归分析证实既往心肌梗死与FVIIa呈负相关（p = 0.03），与FBG、总胆固醇（p = 0.02）及冠状动脉疾病严重程度呈正相关（p < 0.001）。总之，在接受心脏导管检查的疑似冠心病患者中，既往有心肌梗死的患者FVIIa降低而FBG升高。然而，FVIIa、FVIIc或FBG水平与冠状动脉疾病严重程度无关，且在稳定型或不稳定型心绞痛患者中相似。
