Plasma level of triglyceride-rich lipoprotein remnants is closely associated with the activation of coagulation factor VII in patients with myocardial infarction
M. Saigo et al., Plasma level of triglyceride-rich lipoprotein remnants is closely associated with the activation of coagulation factor VII in patients with myocardial infarction, THROMB RES, 100(1), 2000, pp. 9-17
Remnant-like particles, which have been recognized to be atherogenic deriva
tives of chylomicrons and very low density lipoproteins, can be measured us
ing a new assay kit. The purpose of the present study was to investigate th
e association of remnant-like particles with the coagulation system that ha
s an important role in the pathogenesis of myocardial infarction. We assaye
d blood levels of total cholesterol, triglyceride, HDL-cholesterol, apolipo
proteins, remnant-like particles-cholesterol, remnant-like particles-trigly
ceride, fibrinogen, factor VII antigen, activated factor VII, and tissue fa
ctor in 111 patients with a history of myocardial infarction and 128 contro
l subjects. In simple regression analysis, plasma levels of remnant-like pa
rticles-cholesterol and remnant-like particles-triglyceride showed a signif
icant positive correlation with the levels of activated factor VII (r=0.319
, p<0.001, and r=0.286, p=0.002, respectively) and the activated factor VII
/factor VII antigen ratio (v=0.241,p=0.011, and r=0.249, p=0.008, respectiv
ely) in patients with myocardial infarction. In contrast, there were no sig
nificant differences between remnant-like particles and activated factor VI
I in control subjects. In stepwise multivariate regression analysis, the si
gnificant determinants of activated factor VII were remnant-like particles-
cholesterol (10.2%), apolipoproteins A-I (5.1%), and E (7.1%); for the acti
vated factor VII/factor VII antigen ratio, remnant-like particles-triglycer
ide (6.2%), age at blood sampling (5.1%), and apolipoprotein A-I (4.0%) in
patients with myocardial infarction. However, the significant determinants
of activated factor VII and the activated factor VII/factor VII antigen rat
io were HDL-cholesterol (9.9% and 9.2%, respectively) in control subjects.
It is concluded that remnant-like particles may be a risk factor for myocar
dial infarction by activating the extrinsic coagulation pathway. (C) 2000 E
lsevier Science Ltd. All rights reserved.