engleski

The relationship of FII, FVII, FXIII and fibrinogen levels with conventional risk factors in patients with and without coronary artery disease

BACKGROUND:A number of coagulation factors are required for the cascade of biochemical reactions leading to fibrin formation. The aim of the study was to investigate the relationship between haemostatic factors II(FII), VII(FVII), XIII(FXIII), fibrinogen and conventional coronary artery disease (CAD) risk factors in order to enhance understanding of phenotypic variation in haemostatic factor levels in patients and clinical controls. MATERIALS AND METHODS:The study was performed according to Helsinki Declaration and was approved by the Magdalena Special Hospital for Cardiovascular Surgery and Cardiology Ethic Committee. Association analysis was carried out in 242 subjects with ³ 50% stenosis in at least one of the major coronary vessels (CAD+) and 138 subjects with angiographically excluded disease (CAD-). Data regarding body mass index (BMI), presence of arterial hypertension (AH), diabetes, smoking status or history of myocardial infarction (MI) was obtained on admission. Blood collection and processing were performed according to standardized procedures. Established risk factor ratio (ERF) was calculated by dividing total cholesterol by HLD-cholesterol. Fibrinogen was determined by Clauss method ; FII and FVII by single step clotting assays and FXIII by chromogenic assay on a BCS analyzer (Siemens Diagnostics, Marburg, Germany). Bivariate correlations between variables were analyzed with Pearson’s correlation coefficient, and trendlines were calculated with linear regression analysis. Significance was taken as P<0.05. RESULTS:Median of the FII, FVII, FXIII and fibrinogen levels was not significantly different between the CAD- and CAD+ patients (108.5 vs.111.0 ; 120.6 vs.117.1, 93.2 vs.90.9, 2.5 vs.2.6, respectively)(p>0.05). Females have higher values in compare to males (FII:113.6 vs. 105.9, p=0.005 ; FVII:131.5 vs. 117.9, p=0.006, FXIII:100.6 vs. 92.0, p=0.001, FIB:3.18 vs. 2.8, p=0.006).Fibrinogen correlated with age (R:0.124, p=0.05), FXIII(R:0.285, p=0.01) and FII(R:0.162, p=0.01). Furthermore, FII correlate with BMI (R:0.117, p=0.05), ERF(R:0.174, p=0.01) and FVII (R:0.741, p=0.01) whereas FVII values correlated with ERF(R:0.118, p=0.05) and smoking(R=-0.105, p=0.01). In clinical controls FII, FXIII, FVII activities correlated with AH (R:0.192 ; 0.263, 0.296 at p<0.05, respectively). Obtained fibrinogen values were higher in females than in males(3, 1 vs 2.4, p=0.03). Fibrinogen correlated with FXIII (R:0.405 ; p<0.01), but in males also with age(R:0.234) and smoking(R:0.243). In CAD patients FII correlated with age(R:0.130, p<0.05), AH(R:0.195, p=0.01), ERF(R:0.205, p=0.01), FVII(R:0.795, p=0.01 ) and fibrinogen(R:0.154, p<0.05). Females had a higher FII levels(115.7 vs. 107.8, p=0.07) that correlated with BMI(R:0.279, p<0.05), and higher FXIII in compare to males (99.9 vs. 88.6, p=0.02). FVII was higher in smokers(121.3 vs. 112.3, p=0.030). Fibrinogen correlated with FXIII (0.195, P=0.01). Overall, multiple regression analysis revealed age, sex, AH, EFR and fibrinogen to be independent predictors of FII clotting activity, predicting ~11% of the variability ; AH, ERF and fibrinogen to be independent predictors of FVII clotting activity, predicting ~4% of the variability ; age, sex, AH and fibrinogen to be independent predictors of FXIII activity, predicting ~11% of the variability ; smoking, sex and age to be independent predictors, that explain ~15% of the fibrinogen variability. CONCLUSION:The obtained data suggest that different combination of conventional risk factors may have different effects on coagulation factor activities in different patient’s subgroups. However, more extensive study has to be performed in order to determine a combination of relevant factors contributing to the difference in clotting factor activities.

Arterial thrombosis; Biomarkers; Coagulation factors; Risk factors

oral presentation