PROTHROMBIN ACTIVATION FRAGMENT 1-III COMPLEXES IN PATIENTS WITH ANGINA-PECTORIS - RELATION TO THE PRESENCE AND SEVERITY OF CORONARY ATHEROSCLEROSIS(2 AND THROMBIN ANTITHROMBIN)

Plasma levels of the prothrombin activation fragment 1 + 2 (F1 + 2) an d of thrombin antithrombin III complexes (TAT) were determined in 225 patients with angina pectoris undergoing coronary angiography. Oral an ticoagulant therapy was associated with a marked reduction in mean F1 + 2 (0.63 vs 1.62 nmol/l, p < 0.0001) and TAT levels (1.65 vs 2.23 mug /l, p < 0.0001). Omitting patients on oral anticoagulants, TAT values showed a positive association with patients' age (r = 0.18; p = 0.01) and were slightly higher in patients with a history of myocardial infa rction than in those without (2.47 vs 2.11 mug/l; p = 0.06). Both F1 2 and TAT levels were increased in patients with angiographically ver ified coronary atherosclerosis as compared to patients with angina and angiographically normal coronaries (F1 + 2: 1.76 vs 1.36 nmol/l, TAT: 2.35 vs 2.00 mug/l; p-values after adjusting for age, sex and past hi story of myocardial infarction 0.06 and 0.11 respectively). However, n o graded relationship between F1 + 2 or TAT values and severity of ath erosclerosis was observed. This study provides suggestive evidence tha t a procoagulant state exists in patients with angina pectoris and cor onary atherosclerosis. Its relevance in predicting coronary ischaemic events needs to be studied prospectively.