Association of Variables of Coagulation, Fibrinolysis and Acute-phase with Atherosclerosis in Coronary and Peripheral Arteries and those Arteries Supplying the Brain

Abstract

SummaryWe investigated the vessel status of coronary and peripheral arteries and those arteries supplying the brain in 929 consecutive male patients admitted to a coronary rehabilitation unit. The severity of coronary atherosclerosis was scored using coronary angiography. Changes in extracranial brain vessels and manifest cerebrovascular disease (CVD) were determined by B-mode ultrasound and Doppler examination. Peripheral arterial disease (PAD) was diagnosed using base-line and stress oscillography. We assessed variables of coagulation, fibrinolysis, and the acute phase response.There was a significant increase in plasma fibrinogen, plasminogen, d-dimer and C-reactive protein (CRP) with increasing severity of coronary heart disease. Compared to men with unaffected arteries, men with 3 diseased coronary arteries had 58% greater d-dimer concentrations. Patients with CVD and PAD, respectively, also had significantly higher fibrinogen, d-dimer and CRP concentrations. We did not find an association between plasminogen activator inhibitor activity and the severity of coronary atherosclerosis.In conclusion, plasma fibrinogen, d-dimer and CRP concentrations were significantly related to atherosclerosis in the coronary, peripheral and extracranial brain arteries.

C‐reactive protein as a marker for active coronary artery disease in patients with chest pain in the emergency room

“…9 These studies were followed by several angiographic series and by cross-sectional and case-control studies, suggesting that CRP concentrations correlated directly with the presence and severity of coronary, cerebral, and peripheral arterial atherosclerosis. [10][11][12] In addition, various studies examined CRP concentrations among patients with angina pectoris. Liuzzo et al 13 reported that in patients admitted to the hospital with acute unstable angina, CRP levels above 3 mg/l were associated with a significantly worse prognosis.…”

Systemic Inflammatory Parameters in Patients With Atherosclerosis of the Coronary and Peripheral Arteries

“…8 A third acute-phase reactant of interest is fibrinogen. 9,10 Numerous workers have reported an increase in fibrinogen in atherosclerosis, 11,12 but it is unclear whether this elevation is mainly a cause or a result of the disease, although both may be true. The acute-phase response is under tight control of interleukin 6 (IL-6), 13 which is produced to a large extent by macrophages.…”

Stromelysin-1 and Interleukin-6 Gene Promoter Polymorphisms Are Determinants of Asymptomatic Carotid Artery Atherosclerosis

“…IL-6 may thus be pivotal in the putative inflammatory pathogenesis of coronary disease. Inflammatory markers are associated with the development of coronary disease, with disease severity, 13 and with the occurrence of coronary events. 14 Data from the Physicians Health Study suggest that this association is still present after an 8-year follow-up period, 15 implying that progression of atheroma may also be associated with raised inflammatory markers.…”