PROGNOSTIC VALUE OF HEMOSTATIC FACTORS IN PATIENTS WITH CORONARY HEART-DISEASE

The study was undertaken to elucidate the role of hemostatic parameter s versus clinical data in the development of myocardial infarction and cardiac death. A total of 56 patients who suffered from angiographica lly documented coronary heart disease were examined. In addition to co ronary angiography, bicycle ergometry, blood lipid measurements perfor med, the authors measured the levels of fibrinogen (FG), C protein, pl asminogen, antiplasmin, fibrinogen/fibrin degradation products, tissue plasminogen activator (TPA) in venous occlusion, its inhibitor. The f ollow-up averaged 718+/-32.4 days. Nine patients developed large myoca rdial infarction, 6 died. In patients with poor prognosis, the baselin e levels of FG and TPA were significantly higher: 3.35+/-0.168 and 2.7 3+/-0.79 g/l (P=0.007) and 129.3+/-67.8+/-6.5 IU/ml (P=0.049), respect ively. A multifactorial discriminant analysis showed that TPA was the first to be of prognostic value in predicting the unfavourable prognos is, whereas FG and the number of coronary arteries with more than 70% narrowing and cholesterol levels were the second, third, and fourth. T hus, it was found that in addition to the levels of cholesterol and th e number of diseased coronary arteries, the levels of TPA and FG appea red to be the most significant determinants of a patient's prognosis.