Increased heparin-releasable platelet factor 4 and D dimer in patients one month after the onset of acute myocardial infarction: persistent activation of platelets and the coagulation/fibrinolytic system.
To evaluate the activity of platelets and the coagulation/fibrinolytic system 1 month after the onset of acute myocardial infarction, we measured the plasma levels of molecular markers, i.e. beta-thromboglobulin, platelet factor 4, thrombin-antithrombin III complex and D dimer, in 16 patients with acute myocardial infarction and in 11 normal subjects. Blood was drawn through a catheter placed in the pulmonary artery before heparin injection. The heparin-releasable platelet factor 4 was calculated by subtracting the level before the injection of 5000 U of heparin, from the level 5 min after injection. The plasma beta-thromboglobulin, thrombin-antithrombin III complex and the D dimer levels in the acute phase of myocardial infarction were 134.9 +/- 121.2, 11.2 +/- 7.1 and 164.4 +/- 115.3 ng/ml, respectively. These values were significantly higher than those in the normal subjects. The plasma levels of beta-thromboglobulin and thrombin-antithrombin III complex, 1 month after the onset (36.6 +/- 16.4 and 4.6 +/- 2.3 ng/ml, respectively) were not significantly different from those of the normal subjects. In contrast, D dimer and heparin-releasable platelet factor 4 were 216.9 +/- 176.9 and 80.5 +/- 29.3 ng/ml, respectively, and significantly higher than in the normal subjects. These findings suggest a latent but persistent activation of the platelets and the coagulation/fibrinolytic system 1 month after the onset of acute myocardial infarction.
Abe
S
S
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Maruyama
I
I
Arima
S
S
Yamaguchi
H
H
Okino
H
H
Hamasaki
S
S
Yamashita
T
T
Nomoto
K
K
Tahara
M
M
Atsuchi
Y
Y
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001780:Blood Coagulation Tests; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005342:Fibrinolysis / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D010447:Peptide Hydrolases / Q000378:metabolism; D010455:Peptides; D015539:Platelet Activation / Q000502:physiology*; D012016:Reference Values; D001620:beta-Thromboglobulin / Q000378:metabolism
D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D010455:Peptides; C046193:antithrombin III-protease complex; D001620:beta-Thromboglobulin; C036309:fibrin fragment D; C009862:connective tissue-activating peptide; C018329:low affinity platelet factor 4; D000990:Antithrombin III; D010447:Peptide Hydrolases