Prevalence of activated protein C resistance in acute myocardial infarction in Japan.
To investigate the possibility that activated protein C (APC) resistance due to the factor V could be an important predisposing factor in acute myocardial infarction (AMI), we have retrospectively examined the prevalence of APC resistance with protein C, protein S and antithrombin III deficiency and antiphospholipid antibody syndrome in AMI patients (< or = 50 years) admitted to our hospital over the past 7 years. Forty-seven patients were enrolled in the study. We divided the patients into two groups, warfarin group (group A) and a non-warfarin group (group B). APC resistance is defined as when the APC ratio is below or equal to the cut-off value 2. APC resistance was not detected in either group. The prevalence of an APC ratio below or equal to 2.5 was 16.7% (1 case) in group A and 24.4% (10 cases) in group B. The prevalence of protein C deficiency was 5.0% (2 cases) in group B. Two cases (5.0%) in group B had protein S deficiency. Antithrombin III deficiency was not detected in either group. The prevalence of antiphospholipid antibody syndrome measured by APTT was 40.4% (19 cases). We compared the AMI patients with 97 healthy volunteers (< or = 50 years old) without any thromboembolic events or bleeding tendency in their past history. No significant difference were found between these groups and the volunteers. APC resistance is a major cause of venous thromboembolism in Europe and the United States, while in Japan it is believed to be a minor cause of arterial thromboembolism.
Hayashi
K
K
Department of Internal Medicine II, Nagoya University School of Medicine, Japan.
Sone
T
T
Kondoh
J
J
Tsuboi
H
H
Sassa
H
H
Numaguchi
Y
Y
Toki
Y
Y
Okumura
K
K
Ito
T
T
Hayakawa
T
T
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000097:blood; D020152:Antithrombin III Deficiency; D001777:Blood Coagulation; D005165:Factor V / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology; D011486:Protein C / Q000378:metabolism*; D017293:Protein S / Q000378:metabolism*; D018455:Protein S Deficiency / Q000097:blood; D012189:Retrospective Studies
D011486:Protein C; D017293:Protein S; D005165:Factor V