Prothrombotic markers and early spontaneous recanalization in ST-segment elevation myocardial infarction

Marie-Geneviève Huisse; Emilie Lanoy; Didier Tcheche; Laurent J. Feldman; Annie Bezeaud; Eduardo Anglès-Cano; Murielle Mary-Krause; Dominique de Prost; Marie-Claude Guillin; Gabriel P. Steg

doi:10.1160/TH06-11-0621

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2007; 98(02): 420-426
DOI: 10.1160/TH06-11-0621

Cardiovascular Biology and Cell Signalling

Schattauer GmbH

Prothrombotic markers and early spontaneous recanalization in ST-segment elevation myocardial infarction

Marie-Geneviève Huisse

¹AP-HP, Hôpital Bichat, Departments of Haematology and

⁴CIB PhenoGen; University Paris7-Denis Diderot

⁵INSERM U698; University Paris7-Denis Diderot

,

Emilie Lanoy

³U720 ; University Paris7-Denis Diderot

⁶University Pierre et Marie Curie-Paris 6, Paris, France

,

Didier Tcheche

²Departments of Cardiology

,

Laurent J. Feldman

²Departments of Cardiology

⁵INSERM U698; University Paris7-Denis Diderot

,

Annie Bezeaud

⁴CIB PhenoGen; University Paris7-Denis Diderot

⁵INSERM U698; University Paris7-Denis Diderot

,

Eduardo Anglès-Cano

⁵INSERM U698; University Paris7-Denis Diderot

,

Murielle Mary-Krause

³U720 ; University Paris7-Denis Diderot

⁶University Pierre et Marie Curie-Paris 6, Paris, France

,

Dominique de Prost

⁴CIB PhenoGen; University Paris7-Denis Diderot

⁵INSERM U698; University Paris7-Denis Diderot

,

Marie-Claude Guillin

¹AP-HP, Hôpital Bichat, Departments of Haematology and

⁴CIB PhenoGen; University Paris7-Denis Diderot

⁵INSERM U698; University Paris7-Denis Diderot

,

Gabriel P. Steg

²Departments of Cardiology

⁵INSERM U698; University Paris7-Denis Diderot

› Author Affiliations

Abstract

Summary

We tested the hypothesis that selected prothrombotic biomarkers might be associated with early spontaneous coronary recanalization in patients with ST-segment elevation acute myocardial infarction (STEMI). We prospectively enrolled 123 patients with STEMI including 53 patients with spontaneous coronary recanalization (cases) and 70 patients with persistent occlusion (controls) at the time of emergent coronary angiography and before angioplasty. All had received aspirin and heparin. Blood samples were collected immediately before angioplasty to measure soluble P-selectin, circulating microparticles originating from platelets (PMPs), granulocytes (GMPs), endothelial cells (EMPs); tissue factor-associated MP (TF-MP); soluble platelet glycoprotein V (sGPV) and prothrombin F1+2; tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) and plasmin-antiplasmin (PAP). A sub-group of 70 patients (35 cases, 35 controls) was available for flow cytometry analysis of platelet P-selectin and activated GPIIb-IIIa. Baseline clinical characteristics did not differ between groups except for more frequent hypertension and dyslipidemia in controls. Platelet activation markers and PMP did not differ between the two groups. Controls had higher numbers of EMPs and GMPs compared to cases, but the difference was no longer significant when corrected for risk factors. Controls differed from cases by higher plasma levels of sGPV [64 (47–84) ng/ml vs. 53 (44–63) ng/ml] and PAP [114(65–225) ng/ml vs. 88 (51–147) ng/ml].The difference persisted after adjustment for risks factors (p=0.031 and 0.037, respectively). Persistent occlusion of the infarct related artery is associated with some markers related to higher thrombin (sGPV) and plasmin (PAP) production but is not associated with markers of platelet activation.

Keywords

Myocardial infarction - thrombin - soluble glycoproteinV - endothelial injury - plasmin-antiplasmin

Full Text

References

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