Combination of thrombophilia markers in acute myocardial infarction of the young.
BACKGROUND
The pathogenesis of arterial thrombotic disease involves multiple genetic and environmental factors related to atherosclerosis and thrombosis. But, there have been very few studies in India which have investigated some of the thrombophilia markers.


OBJECTIVE
To look for combined thrombophilia in MI patients.


METHODS
One hundred twenty patients of myocardial infarction (age below 40 yrs.) were recruited 8-10 weeks after stabilization. Hundred age and sex-matched healthy controls were also recruited in the present study.


METHODS
Following thrombophilia markers were screened in these patients--plasma fibrinogen, protein C, protein S, antithrombin III, factor V Leiden, PT G20210A polymorphism, MTHFR C677T, homocysteine, fibrinogen b448 Arg/Lys polymorphism and CBS T833C mutation.


METHODS
Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 10.0, SPSS Inc., Chicago, USA.


CONCLUSIONS
Elevated fibrinogen levels, homocysteine (p< 0.001 and homocysteine with odds ratio 6.26) and factor V Leiden (p=0.038) were independently associated with MI in our patients. A total of 37 patients (42.5%) had the presence of more than one thrombophilia markers in combination. Out of these, 10 had the presence of three markers in combination and 1 had five thrombophilia markers in combination. Only 2 controls had prothrombotic markers in combination. Combined prothrombotic risk factors were significant in cases in comparison to controls (p< 0.001). Further larger studies on a nationwide basis recruiting a large number of young MI patients should be done to substantiate these findings.
Khare
Amit
A
Institute of Immunohaematology (I.C.M.R.), 13th Floor New Building, KEM Hospital, Parel, Mumbai-400 012, India.
Ghosh
Kanjaksha
K
Shetty
Shrimati
S
Kulkarni
Bipin
B
Mohanty
Dipika
D
D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004452:Echocardiography; D004591:Electrophoresis, Polyacrylamide Gel; D005165:Factor V / Q000235:genetics / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D017354:Point Mutation; D011486:Protein C / Q000378:metabolism; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood* / Q000150:complications
D015415:Biomarkers; D011486:Protein C; C095381:factor V Leiden; D006710:Homocysteine; D000990:Antithrombin III; D005165:Factor V; D005340:Fibrinogen