title: Low protein Z plasma level is a risk factor for acute myocardial infarction in coronary atherosclerosis disease patients.
abstract: OBJECTIVE
  To examine plasma protein Z (PZ) levels in acute myocardial infarction (AMI) and chronic coronary atherosclerosis disease (CCAD) patients without history of AMI and explore its potential clinical significance.
  
  
  METHODS
  Plasma PZ concentrations were measured in 90 AMI patients (Group A), 87 CCAD patients without AMI history who remained free of major clinical events at least one year (Group B), and 88 clinically healthy controls (Group C).
  
  
  RESULTS
  PZ was found to be significantly lower (P<0.001) in Group A (1508.5±486.2ng/mL) compared with Group B (1823.0±607.8ng/mL) and C (2001.7±733.0ng/mL) and in Group A+B compared with Group C (Group A+B 1663.1±570.0 ng/mL, P<0.001). No statistically significant difference was reached between Group B and C (P=0.081). PZ level was significantly correlated with concentration of creatine kinase MB, high sensitive-cardiac troponin T, high sensitive C reactive protein, D-dimer and coagulation factor II and may be a useful predictor for AMI (OR: 1.38, 95% CI: 1.13-1.77, P=0.03). Subgroup analysis showed PZ concentration below the lowest tertile (<1398ng/mL) had a significantly increased risk for AMI and CCAD (OR: 3.39; 95% CI: 1.12-10.31; P=0.03 and OR: 7.39; 95% CI: 2.62-20.79; P<0.001 respectively).
  
  
  CONCLUSIONS
  PZ deficiency is found in AMI patients and could potentially reflect the myocardium injury, local coagulation activation and inflammation response during the acute phase of coronary atherosclerosis disease.
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Baoxin
authors: B
authors: Liu
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Yong
authors: Y
authors: Li
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Jiachen
authors: J
authors: Luo
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Liming
authors: L
authors: Dai
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Jinlong
authors: J
authors: Zhao
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Hongqiang
authors: H
authors: Li
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Qiqiang
authors: Q
authors: Jie
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors: Dongzhi
authors: D
authors: Wang
authors: Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, United States. Electronic address: xinhuang@uic.edu.
authors: Xin
authors: X
authors: Huang
authors: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China. Electronic address: ywei@tongji.edu.cn.
authors: Yidong
authors: Y
authors: Wei
mesh_terms: D000368:Aged; D001777:Blood Coagulation; D001798:Blood Proteins / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications*; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology*; D012307:Risk Factors
chemical_list: D001798:Blood Proteins; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; C026080:plasma protein Z; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form
keywords: Blood coagulation; Coronary atherosclerosis; Inflammation; Myocardial infarction; Plasma protein Z