title: Plasma heparin cofactor II activity is an independent predictor of future cardiovascular events in patients after acute myocardial infarction.
abstract: OBJECTIVE
  This study tested the hypothesis that plasma heparin cofactor II (HCII) activity independently predicts cardiovascular events in patients after acute myocardial infarction (AMI) and attempted to elucidate the role of HCII in atherothrombosis.
  
  
  BACKGROUND
  HCII inhibits thrombin activity by binding to dermatan sulfate and has been shown to be a novel and independent risk factor for atherosclerosis. However, there is limited data on the relation between plasma levels of HCII after AMI and future cardiovascular events.
  
  
  METHODS
  A total of 110 consecutive patients (aged 63+/-11 years) with AMI were followed up for 42+/-12 months. Plasma HCII activity was determined from blood samples collected immediately after hospitalization. The primary end point was the combined occurrence of major adverse cardiovascular events (MACE), including rehospitalization because of unstable angina, nonfatal MI, revascularization with either percutaneous coronary intervention or coronary artery bypass grafting, ischemic stroke, and cardiovascular death.
  
  
  RESULTS
  All patients were divided into three groups: a high-HCII group (>122%, n=35), a normal-HCII group (>98% and <or=122%, n=41), and a low-HCII group (<or=98%, n=34). The high-HCII group had reduced MACE compared with the other groups, although the difference was not significant (P=0.150). Enhanced plasma HCII activity was, however, significantly associated with decreased MACE in the nondiabetic patients (P=0.034). In a Cox multivariate regression analysis that included all patients, plasma HCII activity was an independent predictor of future MACE (P=0.029).
  
  
  CONCLUSIONS
  The results indicate a potential association between plasma HCII activity and future cardiovascular events after AMI. Moreover, HCII activity seems to play a pivotal role in atherothrombosis.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shao-Sung
authors.initials: SS
authors.lastname: Huang
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.forename: Ying-Hwa
authors.initials: YH
authors.lastname: Chen
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.forename: Kuang-Hsing
authors.initials: KH
authors.lastname: Chiang
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D001026:Coronary Artery Bypass; D018572:Disease-Free Survival; D005260:Female; D015844:Heparin Cofactor II / Q000032:analysis*; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications; D010359:Patient Readmission; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C047932:SERPIND1 protein, human; D015844:Heparin Cofactor II