title: Elevated levels of plasma prekallikrein, high molecular weight kininogen and factor XI in coronary heart disease.
abstract: Increased levels of hemostatic factors may play a role in the pathogenesis of myocardial infarction by triggering thrombin formation. We measured factor XII (FXII), factor XI (FXI), plasma prekallikrein (PK) and high-molecular-weight kininogen (HK) in 200 patients having survived myocardial infarction for at least 2 months, and in 100 healthy controls. We found significantly elevated levels of FXI clotting activity (FXI:C), HK:C and of the amidolytic activity of PK (PK:Am) among the patients as compared to the controls. Plasma levels of FXI:C, HK:C and PK:Am in the highest quartile were associated with an odds ratio of 1.9 (95% CI: 1.0-3.8), 2.0 (95% CI: 1.0-4.0) and 5.4 (95% CI: 2.6-11.2), respectively, compared to the respective plasma levels in the lowest quartile. After correction for established clinical and laboratory risk factors, the association between PK:Am plasma levels and myocardial infarction remained significant (P=0.0007). Combination of high PK:Am plasma levels and smoking or arterial hypertension, respectively, resulted in a more than additive relative risk for myocardial infarction.
authors.affiliation: Central Hematology Laboratory, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Merlo
authors.forename: Walter A
authors.initials: WA
authors.lastname: Wuillemin
authors.forename: Maurice
authors.initials: M
authors.lastname: Redondo
authors.forename: Miha
authors.initials: M
authors.lastname: Furlan
authors.forename: Irmela
authors.initials: I
authors.lastname: Sulzer
authors.forename: Johanna
authors.initials: J
authors.lastname: Kremer-Hovinga
authors.forename: Bernd R
authors.initials: BR
authors.lastname: Binder
authors.forename: Bernhard
authors.initials: B
authors.lastname: Lämmle
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005172:Factor XI / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D019679:Kininogen, High-Molecular-Weight / Q000032:analysis / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology*; D016017:Odds Ratio; D011288:Prekallikrein / Q000032:analysis / Q000378:metabolism*; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D019679:Kininogen, High-Molecular-Weight; D005172:Factor XI; D011288:Prekallikrein