Manten A, de Winter R J, Minnema M C, ten Cate H, Lijmer J G, Adams R, Peters R J, van Deventer S J
Center for Hemostasis, Thrombosis, Atherosclerosis, and Inflammation Research, Academic Medical Hospital, Amsterdam, Netherlands.
Cardiovasc Res. 1998 Nov;40(2):389-95. doi: 10.1016/s0008-6363(98)00130-8.
Both the hemostatic and inflammatory system are thought to play a role in the pathogenesis of acute coronary syndromes. However, their respective contribution and interrelationship remain unclear, therefore, we studied the relationship between activation of the coagulation system and proinflammatory activity in ischemic coronary syndromes.
Thrombin-antithrombin III (TAT), prothrombin fragments F1 + 2, fibrinopeptide A (FPA), interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured in 50 patients with unstable angina (UA), 60 patients with acute myocardial infarction (AMI) and in 50 patients with stable angina (SA).
FPA levels were significantly higher in patients with UA and AMI than in patients with SA (p = 0.0015 and p < 0.0001), and were higher in patients with AMI than UA (p = 0.0013). Plasma IL-6 concentrations were significantly higher in patients with UA and AMI than in patients with SA (p = 0.0020 and p < 0.001), and again were higher in AMI than UA (p = 0.001). Interestingly, FPA or IL-6 elevations on admission were found in different patients. In contrast, TAT, F1 + 2 and IL-8 levels were not different between the three groups.
IL-6 and FPA were shown to be independent predictive markers with equal discriminative power to distinguish stable (SA) from unstable (UA + AMI) patients. Moreover, hemostatic and inflammatory markers can be elevated independently in the acute phase of ischemic coronary syndromes.
止血系统和炎症系统均被认为在急性冠脉综合征的发病机制中发挥作用。然而，它们各自的作用及相互关系仍不明确。因此，我们研究了缺血性冠脉综合征中凝血系统激活与促炎活性之间的关系。
对50例不稳定型心绞痛（UA）患者、60例急性心肌梗死（AMI）患者和50例稳定型心绞痛（SA）患者测定了凝血酶 - 抗凝血酶III（TAT）、凝血酶原片段F1 + 2、纤维蛋白肽A（FPA）、白细胞介素 - 6（IL - 6）和白细胞介素 - 8（IL - 8）。
UA和AMI患者的FPA水平显著高于SA患者（p = 0.0015和p < 0.0001），且AMI患者的FPA水平高于UA患者（p = 0.0013）。UA和AMI患者的血浆IL - 6浓度显著高于SA患者（p = 0.0020和p < 0.001），同样AMI患者的IL - 6浓度高于UA患者（p = 0.001）。有趣的是，入院时FPA或IL - 6升高见于不同患者。相比之下，三组之间TAT、F1 + 2和IL - 8水平无差异。
IL - 6和FPA被证明是独立的预测标志物，具有同等的鉴别能力以区分稳定型（SA）与不稳定型（UA + AMI）患者。此外，在缺血性冠脉综合征急性期，止血和炎症标志物可独立升高。
