title: [Thrombogenic and endothelial damage markers in patients with ischemic systolic impairment].
abstract: BACKGROUND
  Anticoagulation is rarely indicated in patients with left ventricular dysfunction who show an increased risk for thromboembolism. In theory, the three arms of the Virchow' triad may be present: abnormal blood flow, endothelial damage and prothrombotic markers. The aim of this study was to identify the last two arms.
  
  
  METHODS
  We studied 82 consecutive patients with demonstrated ischaemic heart disease and sinus rhythm, and compared them with a control group comprised of 32 healthy subjects matched for age and sex. None or the patients had had an acute coronary event or hemodynamic decompensation within the 3 months prior to inclusion in the study. The plasma concentration or von Willebrand factor and fibrin d-dimer and fibrinogen were determined as endothelial damage and prothrombotic markers, respectively. A fractional shortening less than 29% by echography was defined as ventricular systolic dysfunction.
  
  
  RESULTS
  The patients showed significantly higher levels of von Willebrand factor with respect to the control group (109.2 31.9 vs 85.5 32.6%, p < 0.01), with no differences in fibrinogen and fibrin d-dimer values. Twenty-six patients fulfilled criteria of left ventricular systolic dysfunction. Patients with left ventricular dysfunction showed higher fibrinogen (386 118 vs 322 102 mg/dl, p = 0.03) and fibrin d-dimer (0.36 0.22 vs 0.26 0.10 g/ml; p = 0.04) levels, with no differences in von Willebrand factor levels.
  
  
  CONCLUSIONS
  After acute coronary events, patients with ischaemic heart disease show markers of endothelial damage. However, patients with left ventricular dysfunction show a hypercoagulable state.
authors.affiliation: Servicio de Cardiología. Hospital General Universitario de Alicante.
authors.forename: V
authors.initials: V
authors.lastname: Roldán Schilling
authors.forename: F
authors.initials: F
authors.lastname: Marín Ortuño
authors.forename: J
authors.initials: J
authors.lastname: Pineda Rocamora
authors.forename: V E
authors.initials: VE
authors.lastname: Climent Payá
authors.forename: J G
authors.initials: JG
authors.lastname: Martínez Martínez
authors.forename: P
authors.initials: P
authors.lastname: Marco Vera
authors.forename: L
authors.initials: L
authors.lastname: de Teresa Parreño
authors.forename: F
authors.initials: F
authors.lastname: Sogorb Garri
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014841:von Willebrand Factor; D005340:Fibrinogen