Prothrombin fragments F1+2, thrombin-antithrombin III complexes, fibrin monomers and fibrinogen in patients with coronary atherosclerosis

We determined the plasma levels of prothrombin fragment F1+2, thrombin-anti thrombin III complexes (TAT), fibrin monomers (FM), D-dimers (DD) and fibri nogen in 57 patients with angiographically verified graded coronary artery disease (CAD) free of concomitant peripheral atherosclerosis, cerebrovascul ar disease or diabetes mellitus and a group of 21 apparently healthy contro ls. Blood was collected from the antecubital vein through atraumatic venipunctu re prior to the angiographic procedure. Plasma levels of hemostatic markers were related to the presence and graded severity of CAD. The levels of pro thrombin fragment F1+2 (1.74+/-0.11 vs. 1.0+/-0.07 nmol/l, P<0.001), FM (41 .6+/-5.5 vs. 7.42+/-3.05 nmol/l, P<0.001), TAT (15.6+/-2.7 vs. 2.96+/-0.32 mu g/l, P<0.001) and fibrinogen (3.64+/-1.3 vs. 3.08+/-0.33 g/l, P<0.01) we re significantly higher in patients with CAD compared to controls, while th ere was no difference regarding the fibrinolytic system represented by DD ( 441.6+/-58.9 vs. 337.4+/-42.05 mu g/l, n.s.). Within the CAD group, patient s with extensive coronary atherosclerosis (greater than or equal to 2 vesse l disease) had significantly higher values for prothrombin fragment F1+2 (1 .89 vs. 1.57 nmol/l, P=0.04), FM (50.7 vs. 29.8 nmol/l, P=0.03), and a tren d to significance was noted for fibrinogen (3.9 vs. 3.3 g/l, P=0.07) sugges ting that blood coagulability was related to the severity of the disease an d that hemostatic markers of thrombin activity represent a useful tool to i dentify patients with a latent hypercoagulable state with a higher suscepti bility to sustain coronary thrombosis. (C) 1999 Elsevier Science Ireland Lt d All rights reserved.