Tissue factor and coagulation factor VII levels during acute myocardial infarction: association with genotype and adverse events.
OBJECTIVE
We investigated in patients with ongoing myocardial infarction (MI) whether coagulation factor VII (FVII) and tissue factor (TF) levels are affected at admission by genetic components and whether they may predict subsequent cardiovascular events.


RESULTS
256 patients admitted for MI were evaluated for FVII and TF antigen levels before any treatment at entry, and were genotyped for FVII and TF polymorphisms. FVII gene insertions at -323, 11293 and the -402G/A change predicted FVII levels and explained 14% of variance. The -603 TF gene polymorphism failed to affect significantly TF levels (P=0.07). These variables were correlated with the incidence of death (36 patients) and reinfarction (9 patients) after a median follow-up of 397 days. Events were independently predicted by FVII (HR 2.1, 95% CI 1.2 to 5.7) and TF (HR 4.1, 95% CI 2 to 11) levels. Composite end point was significantly worse when both parameters were above the receiver-operating characteristics (ROC) values (HR 8.3, 95% CI 5 to 18, compared with FVII and TF below), and above the ROC value of TF (>630 pg/mL) it differed among FVII genotype groups.


CONCLUSIONS
Admission FVII and TF antigen levels, partially predicted by polymorphisms, are independent predictors of mortality and reinfarction in patients with acute MI.
Campo
Gianluca
G
Department of Cardiology, University of Ferrara, 44100 Ferrara, Italy.
Valgimigli
Marco
M
Ferraresi
Paolo
P
Malagutti
Patrizia
P
Baroni
Marcello
M
Arcozzi
Chiara
C
Gemmati
Donato
D
Percoco
Gianfranco
G
Parrinello
Giovanni
G
Ferrari
Roberto
R
Bernardi
Francesco
F
D000368:Aged; D018450:Disease Progression; D005167:Factor VII / Q000009:adverse effects / Q000235:genetics* / Q000378:metabolism*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000235:genetics* / Q000378:metabolism* / Q000401:mortality; D011110:Polymorphism, Genetic / Q000235:genetics; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D013925:Thromboplastin / Q000009:adverse effects / Q000235:genetics* / Q000378:metabolism*
D005167:Factor VII; D013925:Thromboplastin