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Changes in levels of factor VII and protein S after acute myocardial infarction: effects of low-dose warfarin

Holm, Johan LU ; Hillarp, Andreas LU ; Erhardt, Leif RW LU and Berntorp, Erik LU (1999) In Thrombosis Research 96(3). p.205-212
Abstract
Persistent coagulation activity after an acute myocardial infarction may increase the risk of reinfarction. We prospectively investigated the effects on plasma coagulation of a low, fixed dose of warfarin in combination with aspirin after myocardial infarction. We also evaluated the influence of coagulation activity on clinical outcome. Plasma samples from 97 patients, randomised to 1.25 mg of warfarin daily in combination with 75 mg of aspirin or aspirin alone were drawn 4 days, 1 month, and 6 months after myocardial infarction. Patients receiving warfarin had a greater reduction in factor VII coagulation activity (FVII:C) after 6 months: 0.18 vs. 0.06 U/mL,(95% CI, 0.02-0.22), whereas no differences were seen in levels of protein C,... (More)
Persistent coagulation activity after an acute myocardial infarction may increase the risk of reinfarction. We prospectively investigated the effects on plasma coagulation of a low, fixed dose of warfarin in combination with aspirin after myocardial infarction. We also evaluated the influence of coagulation activity on clinical outcome. Plasma samples from 97 patients, randomised to 1.25 mg of warfarin daily in combination with 75 mg of aspirin or aspirin alone were drawn 4 days, 1 month, and 6 months after myocardial infarction. Patients receiving warfarin had a greater reduction in factor VII coagulation activity (FVII:C) after 6 months: 0.18 vs. 0.06 U/mL,(95% CI, 0.02-0.22), whereas no differences were seen in levels of protein C, protein S, or prothrombin fragment 1+2. In the acute phase, the level of free protein S was lower than after 6 months in both groups: 25.6 vs. 28.8% (95% CI, 4.19--2.35). Cardiovascular mortality, reinfarction, and stroke were evaluated after 4 years (median). In a survival analysis, every 0.1 U/mL increase in the level of FVII:C1 month after myocardial infarction was associated with an 15% increase in risk of cardiovascular events (95% C1, 1.01-1.30). Warfarin at 1.25 mg daily reduces FVII:C but not systemic thrombin generation measured as prothrombin fragment 1 +2. Low levels of the anticoagulant protein S may contribute to a procoagulant state. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Factor VII, Protein S, Prothrombin fragment 1+2, Warfarin, Myocardial infarction
in
Thrombosis Research
volume
96
issue
3
pages
205 - 212
external identifiers
  • pmid:10588463
  • scopus:0032754587
ISSN
1879-2472
DOI
10.1016/S0049-3848(99)00099-7
language
English
LU publication?
yes
id
14a9600c-6744-492e-8cd3-576721a94b3f (old id 1114912)
date added to LUP
2008-07-07 10:54:07
date last changed
2017-01-01 04:53:43
@article{14a9600c-6744-492e-8cd3-576721a94b3f,
  abstract     = {Persistent coagulation activity after an acute myocardial infarction may increase the risk of reinfarction. We prospectively investigated the effects on plasma coagulation of a low, fixed dose of warfarin in combination with aspirin after myocardial infarction. We also evaluated the influence of coagulation activity on clinical outcome. Plasma samples from 97 patients, randomised to 1.25 mg of warfarin daily in combination with 75 mg of aspirin or aspirin alone were drawn 4 days, 1 month, and 6 months after myocardial infarction. Patients receiving warfarin had a greater reduction in factor VII coagulation activity (FVII:C) after 6 months: 0.18 vs. 0.06 U/mL,(95% CI, 0.02-0.22), whereas no differences were seen in levels of protein C, protein S, or prothrombin fragment 1+2. In the acute phase, the level of free protein S was lower than after 6 months in both groups: 25.6 vs. 28.8% (95% CI, 4.19--2.35). Cardiovascular mortality, reinfarction, and stroke were evaluated after 4 years (median). In a survival analysis, every 0.1 U/mL increase in the level of FVII:C1 month after myocardial infarction was associated with an 15% increase in risk of cardiovascular events (95% C1, 1.01-1.30). Warfarin at 1.25 mg daily reduces FVII:C but not systemic thrombin generation measured as prothrombin fragment 1 +2. Low levels of the anticoagulant protein S may contribute to a procoagulant state.},
  author       = {Holm, Johan and Hillarp, Andreas and Erhardt, Leif RW and Berntorp, Erik},
  issn         = {1879-2472},
  keyword      = {Factor VII,Protein S,Prothrombin fragment 1+2,Warfarin,Myocardial infarction},
  language     = {eng},
  number       = {3},
  pages        = {205--212},
  series       = {Thrombosis Research},
  title        = {Changes in levels of factor VII and protein S after acute myocardial infarction: effects of low-dose warfarin},
  url          = {http://dx.doi.org/10.1016/S0049-3848(99)00099-7},
  volume       = {96},
  year         = {1999},
}