Thromb Haemost 1999; 82(05): 1403-1405
DOI: 10.1055/s-0037-1614844
Rapid Communications
Schattauer GmbH

Elevated High Molecular Weight Fibrinogen in Plasma Is Predictive of Coronary Ischemic Events after Acute Myocardial Infarction

Edelmiro Reganon
1   From the Research Center, Coronary Care Unit and Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
,
Virtudes Vila
1   From the Research Center, Coronary Care Unit and Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
,
Fernando Ferrando
1   From the Research Center, Coronary Care Unit and Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
,
Vicenta Martínez-Sales
1   From the Research Center, Coronary Care Unit and Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
,
Laura Fayos
2   Coronary Care Unit and Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
,
Miguel Ruano
2   Coronary Care Unit and Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
,
Justo Aznar
3   Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain
› Author Affiliations
Further Information

Publication History

Received 19 March 1999

Accepted after revision 16 June 1999

Publication Date:
09 December 2017 (online)

Summary

This study investigates the association between the concentration and function of plasma fibrinogen molecules measured at the time of hospital admission in patients with acute myocardial infarction (AMI), with reference to the risk of new coronary ischemic events during a three-day follow-up period of. Before starting fibrinolytic and anticoagulant treatment plasma fibrinogen, high molecular weight fibrinogen (HMW-fibrinogen), fibrin formation rate (FbFR) and phosphorous content in fibrinogen were determined in 90 AMI patients. During a three-day follow-up period 12 patients suffered new ischemic events. The 12 patients with coronary ischemia had higher concentrations of plasma fibrinogen (312 ± 23 vs. 270 ± 73 mg/dl, p <0.05) and HMW-fibrinogen (246 ± 35 vs. 189 ± 23 mg/dl, p <0.001) and a higher FbFR (65 ± 30 vs. 40 ± 25, p <0.001) than patients without these events. No association was found between the phosphorous content in fibrinogen and new coronary ischemic events. We conclude that after myocardial infarction an elevated plasma level of HMW-fibrinogen and a high FbFR value at the time of hospital admission are associated with new coronary ischemic events during a three-day follow-up period.

 
  • References

  • 1 Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. N Engl J Med 1992; 326: 310-8.
  • 2 Meade TW, Mellows S, Brozovic M, Miller GJ, Chakrabarti RR, Nort WR, Haines AP, Stirling Y, Imeson JD, Thompson SG. Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986; ii: 533-7.
  • 3 Ernst E, Resch KL. Fibrinogen as a cardiovascular risk factor: a metaanalysis and review of the literature. Ann Intern Med 1993; 118: 956-63.
  • 4 Ritchie DG, Levy BA, Adams MA, Fuller GM. Regulation of fibrinogen synthesis by plasmin-derived fragments of fibrinogen and fibrin: an indirect feedback pathway. Proc Natl Acad Sci USA 1982; 79: 1530-4.
  • 5 Princen HM, Moshage HJ, Emeis JJ, de Haard HJ, Nieuwenhuizen W, Yap SH. Fibrinogen fragments X, Y, D and E increase levels of plasma fibrinogen and liver mRNAs coding for fibrinogen polypeptides in rats. Thromb Haemost 1985; 53: 212-5.
  • 6 Holm B, Godal HC. Quantification of the three normally-occurring plasma fibrinogens in health and during so-called “acute phase” by SDS electrophoresis of fibrin obtained from EDTA-plasma. Thromb Res 1984; 35: 279-90.
  • 7 Vila V, Reganon E, Aznar J, Lacueva V, Ruano M, Laíz B. Hypercoagulable state after thrombolytic therapy in patients with acute myocardial infarction (AMI) treated with streptokinase. Thromb Res 1990; 57: 783-94.
  • 8 Reganon E, Vila V, Aznar J, Lacueva V, Martínez V, Ruano M. Studies on the functionality of newly synthesized fibrinogen after treatment of acute myocardial infarction with streptokinase, increase in the rate of fibrinopeptide release. Thromb Haemost 1993; 70: 978-83.
  • 9 Seydewitz HH, Matthias FR, Schöndorf TH, Witt I. Increase in the degree of phosphorylation of circulating fibrinogen under thrombolytic therapy with urokinase. Thromb Res 1987; 46: 437-45
  • 10 Seydewitz HH, Witt I. The fraction of high molecular weight (HMW) fibrinogen and phosphorylated fibrinopeptide A in fetal fibrinogen. Thromb Res 1989; 55: 785-90.
  • 11 Hasegawa N, Sasaki S. Localization of the binding site “b” for lateral polymerization of fibrin. Thromb Res 1990; 57: 183-95.
  • 12 Holm B, Nilsen DW, Kierulf P, Godal HC. Purification and characterizaion of 3 fibrinogens with different molecular weight obtained from human plasma. Thromb Res 1985; 37: 165-76.
  • 13 Reganon E, Vila V, Aznar J, Laíz B. Human fibrinogen heterogeneity. A study of limited fibrinogen degradation. Clin Chim Acta 1989; 184: 7-18.
  • 14 Seifried E, Oethinger M, Tanswell P, Hoegee-de-Nobel E, Nieuwenhuizen W. Influence of acute myocardial infarction and rt-PA therapy on circulating fibrinogen. Thromb Haemost 1993; 69: 321-7.
  • 15 Low EM, Hill HB, Searcy RL. Simple method for detection of abnormal plasma fibrinogen levels. Tech Bull Regist Med Technol 1967; 37: 72-4.
  • 16 Laemmli UK. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 1970; 227: 680-5.
  • 17 Towbin H, Staehelin T, Gordon J. Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets. Procedure and some applications. Proc Natl Acad Sci USA 1979; 76: 4350-4.
  • 18 Reganon E, Vila V, Aznar J. Gelification of fibrinogen in plasma. A kinetic study by turbidity measurement. Haemostasis 1984; 14: 170-8.
  • 19 Vila V, Reganon E, Llopis F, Aznar J. A rapid method for isolation of fibrinogen from human plasma by precipitation with polyethylene glycol 6,000. Thromb Res 1985; 39: 651-6.
  • 20 Mihalyi E. Physicochemical studies of bovine fibrinogen. IV. Ultraviolet absorption and its relation to the structure of the molecule. Biochemistry 1968; 7: 208-23.
  • 21 Kehl M, Lottspeich F, Henschen A. Analysis of human fibrinopeptides by high-performance liquid chromatography. Hoppe Seylers Z Physiol Chem 1981; 362: 1661-4.
  • 22 Thompson SG, Kienast J, Pyke SDM, Haverkate F, van de Loo JCW. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. N Engl J Med 1995; 332: 635-41.
  • 23 Becker RC, Cannon CP, Bovill EG, Tracy RP, Thompson B, Knatterud GL, Randall A, Braunwald B. Prognostic value of plasma fibrinogen concentration in patients with unstable angina and non-Q-wave myocardial infaction (TIMI IIIB trial). Am J Cardiol 1996; 78: 142-7.