Triglyceride Dependence of Factor VII Coagulant Activity in Deep Venous Thrombosis

Summary

The effect of incubation of plasma with lipoprotein lipase on factor VII coagulant (FVII: C) activity was examined in 40 patients, 22 male and 18 female, aged 28 to 77 years, with history of venograph-ically proven deep venous thrombosis (DVT). While the mean (± SEM) FVII: C activity of the 40 patients was 100.9 ± 4.1%, 19 patients had FVII: C activity less than 100%, 11 had 100 to 120% activity and 10 patients had greater than 120% FVII:C activity. The mean triglyceride level of all the patients was 84.0 ± 6.5 mg/dl. The FVII: C activity correlated significantly with triglyceride (r = 0.36; n = 40; p = 0.021). There was about 30% average loss of FVII: C activity upon incubation of plasma with lipoprotein lipase. The mean activity loss increased from 23.8% to 31.5% and 42.6% in patients whose FVII:C activity levels were less than 100%, between 100 and 120% and more than 120% respectively, the variation in the means being statistically significant (p <0.001). While according to current opinion, FVII:C activity represents the total FVII mass (FVII plus FVIIa) and activity state, the present findings demonstrate a lipid dependence of FVII: C activity, and raises the possibility of a therapeutic option of controlling FVII: C by controlling triglyceride levels.

• References

• 1 Meade TW, Ruddock V, Stirling Y, Chakrabarti R, Miller GJ. Fibrinolytic activity, clotting factors, and long-term incidence of ischaemic heart disease in Northwick Park Heart Study. Lancet 1993; 342: 1076-1079
• 2 Marckmann P, Sandstrom B, Jespersen J. The variability of and associations between measures of blood coagulation, fibrinolysis and blood lipids. Atherosclerosis 1992; 96: 235-244
• 3 Donders SH, Lustermans FA, van Wersch JW. Coagulation factors and lipid composition of the blood in treated and untreated hypertensive patients. Scand J Lab Clin Invest 1993; 53: 179-186
• 4 Burns P, Hoffman CJ, Katz JP, Miller RH, Lawson WE, Hutlin MB. Vitamin K-dependent clotting factors are elevated in young adults who have close relatives with ischemic heart disease. J Lab Clin Med 1993; 122: 720-727
• 5 Boyer C, Wolf M, Rothschild C, Migaud M, Amiral J, Mannucci PM, Meyer D, Larrieu MJ. An enzyme immunoassay (ELISA) for the quantitation of human factor VII. Thromb Haemost 1986; 56: 250-255
• 6 Koster T, Rosendaal FR, Reitsma PH, van der Velden PA, Briët E, Vandenbroucke JP. Factor VII and fibrinogen levels as risk factors for venous thrombosis. A case-control study of plasma levels and DNA polymorphisms - The Leiden Thrombophilia Study (LETS). Thromb Haemost 1994; 71: 719-722
• 7 Dalaker K, Smith P, Amerson H, Prydz H. Factor Vll-phospholipid complex in male survivors of acute myocardial infarction. Acta Med Scand 1987; 222: 111-116
• 8 Dalaker K, Hjermann I, Prydz H. A novel form of factor VII in plasma from men at risk of cardiovascular disease. Brit J Haematol 1985; 61: 315-322
• 9 Dalaker K. Clotting factor VII during pregnancy, delivery and puerperium. Brit J Obst Gynaecol 1986; 93: 17-21
• 10 Morrissey JH. Tissue factor modulation of factor Vila activity: Use in measuring trace levels of factor Vila in plasma. Thromb Haemost 1995; 74: 185-188
• 11 Hubbard AR, Parr LJ. Phospholipase C mediated inhibition of factor VII requires triglyceride rich lipoproteins. Thromb Res 1991; 62: 335-344