[Relation of an increase of von Willebrand factor in the blood, acute myocardial infarction, unstable angina and coronary thrombosis].
Forty six patients admitted for precordial chest pain were included in this study. The clinical, electrocardiographic, enzymatic and angiographic features allowed retrospective identification of 6 subgroups (nos 1 to 6): all transmural myocardial infarction (Q-MI) (Group 1), Q-MI without intracoronary thrombus (Group 2), Q-MI with intracoronary thrombus (Group 3), acute non-Q wave infarction (non Q-MI) (Group 4), unstable angina (Group 5) and atypical chest pain (Group 6). Several blood clotting factors were studied; von Willebrand factor (VWF), fibrinogen, tissue plasminogen activator (t-PA) and its inhibitor (PAI-1) and factor VII. There was no significant difference in the fibrinogen, t-PA, PAI-1 or factor VII levels between the 6 groups. On the other hand, the VWF was increased in the all transmural myocardial infarction (Q-MI) groups (n. 1). In Group 3 with visible intracoronary thrombus the VWF was high or very high in all patients, attaining three times the normal values. The values were lower in Group 5 (unstable angina) patients in whom no thrombus was observed on coronary angiography. The differences between Group 1 and Groups 4, 5 and 6 were statistically significant (p less than 0.05). The VWF was higher in the Q-MI group with intracoronary thrombus than in the group without thrombus, but the difference was not statistically different. In conclusion, the VWF may be considered to be a marker for thrombus and/or endothelial activation but a larger study population would be required to identify more accurately the subgroups with thrombosis or risk of thrombosis.
Mossard
J M
JM
Service de cardiologie, hôpital de Hautepierre, CHU de Strasbourg.
Wiesel
M L
ML
Cazenave
J P
JP
Grunebaum
L
L
Drawin
T
T
Kieny
J R
JR
Roul
G
G
Bareiss
P
P
Sacrez
A
A
D000328:Adult; D000787:Angina Pectoris / Q000097:blood*; D000789:Angina, Unstable / Q000097:blood*; D003327:Coronary Disease / Q000097:blood*; D003328:Coronary Thrombosis / Q000097:blood*; D003402:Creatine Kinase / Q000097:blood; D005167:Factor VII / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D015849:Plasminogen Inactivators / Q000032:analysis; D010959:Tissue Plasminogen Activator / Q000032:analysis; D014841:von Willebrand Factor / Q000032:analysis*
D015849:Plasminogen Inactivators; D014841:von Willebrand Factor; D005167:Factor VII; D005340:Fibrinogen; D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator
Relations entre augmentation du facteur de Willebrand plasmatique, infarctus du myocarde aigu, angor instable et thrombose coronaire.