title: Activated partial thromboplastin time correlates with methoxyhydroxyphenylglycol in acute myocardial infarction patients: therapeutic implications for patients at cardiovascular risk.
abstract: OBJECTIVE
  Acute myocardial infarction (AMI) is associated with increased coagulation which in the presence of unstable atheroma or endothelial damage leads to occlusive coronary vessel thrombosis. AMI is usually characterized by increased levels of catecholamines. It is possible there may be a link between catecholamines and hypercoagulation, but this still remains to be determined. In the current study we sought to verify whether hypercoagulation is associated with hypersympathetic activity in AMI patients, and whether there is a correlation between increased Methoxyhydroxyphenylglycol (MOPEG) levels (a metabolite of catecholamines) and shorter APTT (a marker of hypercoagulation).
  
  
  RESULTS
  Shorter APTT values were detected in the plasma of AMI patients, which had also increased MOPEG levels. A linear correlation between APTT and MOPEG values was observed. High levels of the coagulation marker prothrombin (fragments 1+2) were also found.
  
  
  CONCLUSIONS
  Shortened APTT demonstrates hypercoagulation and high MOPEG levels indicate increased catecholamine metabolism. A direct correlation between APTT and MOPEG was found herein, demonstrating a link between catecholamines and the process of coagulation. Catecholamines may interact with the α2-adrenergic receptors located on platelets and convert factor XII to XIIa or through the kallikrein-kinin system, they may activate factor XII. The activation of factor XII initiates the intrinsic coagulation pathway, which is monitored by APTT. It is suggested to control patients with a shortened APTT and increased sympathetic activity with the aim of preventing secondary coagulation and cardiovascular accidents by administering anti-thrombotic and anti-adrenergic agents.
authors.affiliation: Research Unit "Iraklis Galatoulas" - Department of Medical Biotechnology and Translational Medicine, University of Milan, Via Vanvitelli 32, 20129 - Milan, Italy, arnaldo.pinelli@unimi.it.
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Pinelli
authors.forename: Silvio
authors.initials: S
authors.lastname: Trivulzio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossoni
mesh_terms: D000368:Aged; D001777:Blood Coagulation; D002395:Catecholamines / Q000097:blood; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology; D010314:Partial Thromboplastin Time; D010446:Peptide Fragments / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D013927:Thrombosis / Q000097:blood / Q000473:pathology
chemical_list: D002395:Catecholamines; D010446:Peptide Fragments; D011498:Protein Precursors; D008734:Methoxyhydroxyphenylglycol; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D011516:Prothrombin
keywords: Acute myocardial infarction (AMI); activated partial thromboplastin time (APTT); hypercoagulation; hypersympathetic activity; intrinsic coagulation pathway; methoxyhydroxyphenylglycol (MOPEG); prothrombin fragments F1+2 (F1+2)