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      Changes of Plasma Tissue Factor and Tissue Factor Pathway Inhibitor Antigen Levels and Induction of Tissue Factor Expression on the Monocytes in Coronary Artery Disease


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          Background: Several studies have shown that thrombosis and inflammation play an important role in the pathogenesis of coronary artery disease (CAD). Tissue factor (TF) is responsible for the thrombogenicity of the atherosclerotic plaque and plays a key in triggering thrombin generation. The aim of this study was to assess the levels of TF and tissue factor pathway inhibitor (TFPI) in patients with angiographically documented CAD and also to evaluate TF induction on monocytes in vitro in the presence of these plasmas from patients with CAD. Methods: Plasma antigen levels of soluble TF and TFPI were measured in 65 CAD patients and 22 healthy controls. Surface TF expression on monocytes from a healthy donor treated with plasma samples was evaluated by flow cytometry with a direct double-color immunofluorescence technique. Results: Significantly elevated levels of both TF and TFPI were found in CAD patients compared with healthy controls (303.6 ± 134.1 vs. 187.3 ± 108.7 pg/ml, p < 0.05; 85.2 ± 48.6 vs. 65.0 ± 29.0 ng/ml, p < 0.05). By flow cytometry, monocytes from a healthy donor displayed higher TF antigen expression when incubated in the presence of CAD plasmas than in control plasmas (34.6 ± 10.7 vs. 23.2 ± 10.2%, p < 0.05). Conclusions: The high levels of circulating TF are present in CAD, which were not sufficiently inhibited by the elevated TFPI plasma levels. Although the source of circulating TF is unclear, TF induction of monocytes by plasma from CAD patients may contribute to the hypercoagulable state.

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          Monocyte tissue factor-like activity in post myocardial infarction patients.

          It is widely recognized that thrombosis is the major event in the evolution of stable vascular disease to unstable ischaemic syndromes including myocardial infarction and stroke. The purpose of this case-control study was to establish clinical and laboratory data on the possible relationship between specific components of the haemostatic system and coronary heart disease. The procoagulant activity (PCA) of peripheral monocytes and polymorphonuclear neutrophils was assessed in 21 males who had suffered a myocardial infarction (MI) and in age-matched controls. In addition, total factor VII activity, fibrinogen, tissue factor pathway inhibitor (TFPI). D-dimers, tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), tumour necrosis factor-alpha (TNF-alpha) and full blood counts were measured. Post MI patients had significantly higher monocyte PCA, higher plasma concentrations of TFPI, fibrinogen, t-PA, T/P100 and also higher total white blood cell and neutrophil counts compared to age-matched controls. This elevated procoagulant state in post MI patients could further exacerbate the disease process and increase the risk of subsequent acute ischaemic events.

            Author and article information

            S. Karger AG
            June 2000
            04 July 2000
            : 93
            : 1-2
            : 31-36
            Departments of aClinical Pathology and bInternal Medicine, Yonsei University College of Medicine, Seoul, Korea
            6999 Cardiology 2000;93:31–36
            © 2000 S. Karger AG, Basel

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            Page count
            Figures: 1, Tables: 4, References: 30, Pages: 6
            General Cardiology


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