MONOCYTE TISSUE FACTOR-LIKE ACTIVITY IN POST MYOCARDIAL-INFARCTION PATIENTS

It is widely recognized that thrombosis is the major event in the evol ution of stable vascular disease to unstable ischaemic syndromes inclu ding myocardial infarction and stroke. The purpose of this case-contro l 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 polpmorphonuclear neutrophils was assessed in 21 males who had suffered a myocardial infarction (MI) and in age-matched contr ols. In addition, total factor VII activity, fibrinogen, tissue factor pathway inhibitor (TFPI), D-dimers, tissue plasminogen activator (t-P A), plasminogen activator inhibitor (PRI-1), tumour necrosis factor-al pha (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 d isease process and increase the risk of subsequent acute ischaemic eve nts.