Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events.
In acute coronary syndrome (ACS) cardiac cell damage is preceded by thrombosis. Therefore, plasma coagulation markers may have additional diagnostic relevance in ACS. By using novel coagulation assays this study aims to gain more insight into the relationship between the coagulation system and ACS.W...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4946779?pdf=render |
| _version_ | 1818497433353584640 |
|---|---|
| author | Rinske Loeffen René van Oerle Mathie P G Leers Johannes A Kragten Harry Crijns Henri M H Spronk Hugo Ten Cate |
| author_facet | Rinske Loeffen René van Oerle Mathie P G Leers Johannes A Kragten Harry Crijns Henri M H Spronk Hugo Ten Cate |
| author_sort | Rinske Loeffen |
| collection | DOAJ |
| description | In acute coronary syndrome (ACS) cardiac cell damage is preceded by thrombosis. Therefore, plasma coagulation markers may have additional diagnostic relevance in ACS. By using novel coagulation assays this study aims to gain more insight into the relationship between the coagulation system and ACS.We measured plasma thrombin generation, factor XIa and D-dimer levels in plasma from ACS (n = 104) and non-ACS patients (n = 42). Follow-up measurements (n = 73) were performed at 1 and 6 months. Associations between coagulation markers and recurrent cardiovascular events were calculated by logistic regression analysis.Thrombin generation was significantly enhanced in ACS compared to non-ACS patients: peak height 148±53 vs. 122±42 nM. There was a significantly diminished ETP reduction (32 vs. 41%) and increased intrinsic coagulation activation (25 vs. 7%) in ACS compared to non-ACS patients. Furthermore, compared to non-ACS patients factor XIa and D-dimer levels were significantly elevated in ACS patients: 1.9±1.1 vs. 1.4±0.7 pM and 495(310-885) vs. 380(235-540) μg/L. Within the ACS spectrum, ST-elevated myocardial infarction patients had the highest prothrombotic profile. During the acute event, thrombin generation was significantly increased compared to 1 and 6 months afterwards: peak height 145±52 vs. 100±44 vs. 98±33 nM. Both peak height and factor XIa levels on admission predicted recurrent cardiovascular events (OR: 4.9 [95%CI 1.2-20.9] and 4.5 [1.1-18.9]).ACS patients had an enhanced prothrombotic profile, demonstrated by an increased thrombin generation potential, factor XIa and D-dimer levels. This study is the first to demonstrate the positive association between factor XIa, thrombin generation and recurrent cardiovascular events. |
| first_indexed | 2024-12-10T18:45:42Z |
| format | Article |
| id | doaj.art-deb4372776c64fe588855dc2eee8a873 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T18:45:42Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-deb4372776c64fe588855dc2eee8a8732022-12-22T01:37:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01117e015835510.1371/journal.pone.0158355Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events.Rinske LoeffenRené van OerleMathie P G LeersJohannes A KragtenHarry CrijnsHenri M H SpronkHugo Ten CateIn acute coronary syndrome (ACS) cardiac cell damage is preceded by thrombosis. Therefore, plasma coagulation markers may have additional diagnostic relevance in ACS. By using novel coagulation assays this study aims to gain more insight into the relationship between the coagulation system and ACS.We measured plasma thrombin generation, factor XIa and D-dimer levels in plasma from ACS (n = 104) and non-ACS patients (n = 42). Follow-up measurements (n = 73) were performed at 1 and 6 months. Associations between coagulation markers and recurrent cardiovascular events were calculated by logistic regression analysis.Thrombin generation was significantly enhanced in ACS compared to non-ACS patients: peak height 148±53 vs. 122±42 nM. There was a significantly diminished ETP reduction (32 vs. 41%) and increased intrinsic coagulation activation (25 vs. 7%) in ACS compared to non-ACS patients. Furthermore, compared to non-ACS patients factor XIa and D-dimer levels were significantly elevated in ACS patients: 1.9±1.1 vs. 1.4±0.7 pM and 495(310-885) vs. 380(235-540) μg/L. Within the ACS spectrum, ST-elevated myocardial infarction patients had the highest prothrombotic profile. During the acute event, thrombin generation was significantly increased compared to 1 and 6 months afterwards: peak height 145±52 vs. 100±44 vs. 98±33 nM. Both peak height and factor XIa levels on admission predicted recurrent cardiovascular events (OR: 4.9 [95%CI 1.2-20.9] and 4.5 [1.1-18.9]).ACS patients had an enhanced prothrombotic profile, demonstrated by an increased thrombin generation potential, factor XIa and D-dimer levels. This study is the first to demonstrate the positive association between factor XIa, thrombin generation and recurrent cardiovascular events.http://europepmc.org/articles/PMC4946779?pdf=render |
| spellingShingle | Rinske Loeffen René van Oerle Mathie P G Leers Johannes A Kragten Harry Crijns Henri M H Spronk Hugo Ten Cate Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events. PLoS ONE |
| title | Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events. |
| title_full | Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events. |
| title_fullStr | Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events. |
| title_full_unstemmed | Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events. |
| title_short | Factor XIa and Thrombin Generation Are Elevated in Patients with Acute Coronary Syndrome and Predict Recurrent Cardiovascular Events. |
| title_sort | factor xia and thrombin generation are elevated in patients with acute coronary syndrome and predict recurrent cardiovascular events |
| url | http://europepmc.org/articles/PMC4946779?pdf=render |
| work_keys_str_mv | AT rinskeloeffen factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents AT renevanoerle factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents AT mathiepgleers factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents AT johannesakragten factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents AT harrycrijns factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents AT henrimhspronk factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents AT hugotencate factorxiaandthrombingenerationareelevatedinpatientswithacutecoronarysyndromeandpredictrecurrentcardiovascularevents |