Markers of hypercoagulation, von Willebrand factor and anticardiolipin antibodies in postmenopausal women with unstable coronary artery disease : Discriminatory Ability Regarding Unstable Coronary Artery Disease and Coronary Atherosclerosis Using Receiver Operating Characterstics

• Aims - Many women with typical anginal chest pain have normal coronary angiograms. The pathogenetic mechanisms behind the chest pain in these patients are unknown but may be due to increased thrombogenecity. We evaluated markers of hypercoagulation and thrombosis in women with clinical signs of unstable coronary artery disease (CAD).Methods and results - 158 patients with unstable CAD and 101 controls were examined. 16% of the patients had nonnal vessels and 84% had coronary atherosclerosis at coronary angiography. Mean plasma concentrations of von Willebrand factor-antigen, soluble fibrin (SF), thrombin-antithrombin complex and Ddimer were significantly higher, whereas there was no difference regarding prothrombin fragment 1 +2 between patients and controls. Patients with coronary atherosclerosis had higher mean plasma levels for most variables compared to those with normal coronary vessels, but the only significant difference was for SF. D-dimer was significantly higher in patients with nonnal coronary vessels compared to the control group. Anticardiolipin antibody (ACA) levels were significantly lower in the patient group compared to the control group. Receiver operating characteristics (ROC) showed that none of the variables represented high diagnostic accuracy in distinguishing patients with unstable CAD from healthy controls, or patients with from those without coronary atherosclerosis.Conclusion - Our results are in favour of a hypercoagulable state in postmenopausal women with unstable CAD and coronary atherosclerosis, even in the absence of myocardial marker elevation, whereas this does not seem to be the case in patients with nonnal vessels. ROC revealed no variable to be particularly clinical useful in separating patients and control or patients with and without coronary atherosclerosis.

Keyword

Coagulation

Unstable Coronary Artery Disease

Women

ROC Curve

Cardiolipin

Coronary Atherosclerosis

MEDICINE

MEDICIN

Publication and Content Type

vet (subject category)

ovr (subject category)