Tissue factor/tissue factor pathway inhibitor system and long-term prognosis after acute myocardial infarction

The tissue factor and tissue factor pathway inhibitor (TFPI) system has bee n studied in the acute phase of coronary disease but its: prognostic import ance has been less well assessed. We evaluated its association with recurre nt coronary events during long-term follow-up after a myocardial infarction . Methods: We studied 55 consecutive patients with the following criteria f or inclusion: (1) first myocardial infarct; (2) aged < 70 years, (3) non-co mplicated infarct; (4) low risk effort-test. Blood samples were taken 60-80 days after infarction. Tissue factor, total and free-TFPI were measured. A 4-year follow-up was carried out. Death, unstable angina and new myocardia l infarction were considered as poor prognosis. Results: There were no stat istical differences in tissue factor/TFPI levels between patients and contr ols. Total-TFPI showed statistical correlation with total cholesterol (r=0. 59), triglycerides (r=0.34), LDL-cholesterol (r=0.40) and Lipoprotein(a) (r =0.48). Patients with high levels of cholesterol. LDL-cholesterol and trigl ycerides showed elevated levels of total-TFPI with no differences in free-T FPI. During follow-up, 8 patients showed poor prognosis. There were no stat istical associations between tissue factor/TFPI levels and prognosis. Concl usions: After acute myocardial infarction, we did not find any differences in the tissue factor/TFPI system between controls and patients. The tissue factor/TFPI system showed little value as a prognostic factor. (C) 2001 Els evier Science Ireland Ltd. All rights reserved.