Long-term prognostic value of protein C activity, erythrocyte aggregation and membrane fluidity in transmural myocardial infarction.
The objective of this study was to evaluate the long-term predictive value of the haemostatic, inflammatory and haemorheologic disturbances in transmural myocardial infarction (MI). Sixty-four (59 male) consecutive survivors of a MI, with a mean age of 58.3 +/- 12.0 years, were followed over a period of 36 months. Eighteen patients had a cardiovascular event defined as the composite of death, non-fatal MI, unstable angina and stroke. The haemostatic (protein C activity-PtC, antithrombin III, plasminogen activator inhibitor-1), haemorheologic (blood fluidity and components, erythrocyte membrane fluidity) and inflammatory (polymorphonuclear elastase, leukocyte count) profiles were determined at hospital discharge, using standard methodology. Our results can be summarized as follow: (i) at hospital discharge, the subgroup of patients with events had higher leukoactivity, leukocyte count, membrane fluidity, prognosis cyte count (7833.0 +/- 1696.0 vs. 10294.0 +/- 3129.0; p = 0.011), lower PtC (100.65 +/- 19.08 vs.81.25 +/- 19.95; p = 0.002), and lower erythrocyte aggregation (14.26 +/- 5.94 vs. 11.47 +/- 3.45; p = 0.031) in relation to the ones without events; (ii) By Cox regression the protein C activity lower tertile (OR 0.169; 0.045-0.628; p = 0.008); erythrocyte membrane outer layer fluidity upper tertile (OR 0.067; 95% CI 0.011 - 0.393; p = 0.003); and erythrocyte aggregation lower tertile (OR 0.182; 0.038 - 0.876; p = 0.034) were independent predictors of the composite endpoint. We can conclude that some haemostatic, haemorheologic and inflammatory disturbances, at hospital discharge, are long-term independent predictors of recurrent cardiovascular events in transmural myocardial infarction survivors.
Sargento
Luis
L
Instituto de Bioquímica, Unidade de Biopatologia Vascular-IMM, Faculdade de Medicina de Lisboa, Portugal. Luis.sargento@netcabo.pt
Saldanha
Carlota
C
Monteiro
José
J
Perdigão
Carlota
C
e Silva
J Martins
JM
D000328:Adult; D015415:Biomarkers; D018572:Disease-Free Survival; D004903:Erythrocyte Aggregation; D004910:Erythrocyte Membrane / Q000378:metabolism; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D018056:Hemorheology; D006487:Hemostasis; D006801:Humans; D007249:Inflammation; D008297:Male; D008560:Membrane Fluidity; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000378:metabolism* / Q000401:mortality; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D011486:Protein C / Q000378:metabolism*; D012044:Regression Analysis; D013997:Time Factors
D015415:Biomarkers; D011486:Protein C