Changes of plasma tissue factor and tissue factor pathway inhibitor antigen levels and induction of tissue factor expression on the monocytes in coronary artery disease.
BACKGROUND
Several studies have shown that thrombosis and inflammation play an important role in the pathogenesis of coronary artery disease (CAD). Tissue factor (TF) is responsible for the thrombogenicity of the atherosclerotic plaque and plays a key in triggering thrombin generation. The aim of this study was to assess the levels of TF and tissue factor pathway inhibitor (TFPI) in patients with angiographically documented CAD and also to evaluate TF induction on monocytes in vitro in the presence of these plasmas from patients with CAD.


METHODS
Plasma antigen levels of soluble TF and TFPI were measured in 65 CAD patients and 22 healthy controls. Surface TF expression on monocytes from a healthy donor treated with plasma samples was evaluated by flow cytometry with a direct double-color immunofluorescence technique.


RESULTS
Significantly elevated levels of both TF and TFPI were found in CAD patients compared with healthy controls (303.6 +/- 134.1 vs. 187.3 +/- 108.7 pg/ml, p < 0.05; 85.2 +/- 48.6 vs. 65.0 +/- 29.0 ng/ml, p < 0.05). By flow cytometry, monocytes from a healthy donor displayed higher TF antigen expression when incubated in the presence of CAD plasmas than in control plasmas (34.6 +/- 10.7 vs. 23.2 +/- 10.2%, p < 0.05).


CONCLUSIONS
The high levels of circulating TF are present in CAD, which were not sufficiently inhibited by the elevated TFPI plasma levels. Although the source of circulating TF is unclear, TF induction of monocytes by plasma from CAD patients may contribute to the hypercoagulable state.
Kim
H K
HK
Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea.
Song
K S
KS
Park
Y S
YS
Yun
Y S
YS
Shim
W H
WH
D000328:Adult; D000368:Aged; D000941:Antigens / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D065427:Factor Xa Inhibitors; D005260:Female; D005434:Flow Cytometry; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D008074:Lipoproteins / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000378:metabolism*; D015842:Serine Proteinase Inhibitors / Q000097:blood* / Q000276:immunology; D012720:Severity of Illness Index; D013925:Thromboplastin / Q000378:metabolism*
D000941:Antigens; D015415:Biomarkers; D065427:Factor Xa Inhibitors; D008074:Lipoproteins; D015842:Serine Proteinase Inhibitors; C051928:lipoprotein-associated coagulation inhibitor; D013925:Thromboplastin