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Early identification of acute myocardial infarction by activated protein C-protein C inhibitor complex.

Bhiladvala, Pallonji LU ; Strandberg, Karin LU ; Stenflo, Johan LU and Holm, Johan LU (2006) In Thrombosis Research 118(Aug 10). p.213-219
Abstract
Introduction: Increased coagulation activity due to coronary thrombosis in a ruptured plaque should result in activation of the protein C anticoagulant system with formation of complexes between activated protein C (APC) and,the protein C inhibitor (PCI), which reflects coagulation activity. We hypothesized that elevated APC-PCI concentration might allow earlier detection of ongoing myocardial infarction than traditional biochemical markers. We have evaluated a newly devised immunofluorimetric assay for measuring plasma concentration of APC-PCI complexes among patients with suspected acute coronary syndrome. Materials and methods: Blood samples were taken from 340 patients (median 71 years, range 31-97) with suspected acute coronary... (More)
Introduction: Increased coagulation activity due to coronary thrombosis in a ruptured plaque should result in activation of the protein C anticoagulant system with formation of complexes between activated protein C (APC) and,the protein C inhibitor (PCI), which reflects coagulation activity. We hypothesized that elevated APC-PCI concentration might allow earlier detection of ongoing myocardial infarction than traditional biochemical markers. We have evaluated a newly devised immunofluorimetric assay for measuring plasma concentration of APC-PCI complexes among patients with suspected acute coronary syndrome. Materials and methods: Blood samples were taken from 340 patients (median 71 years, range 31-97) with suspected acute coronary syndrome at first presentation in the emergency department. Electrocardiogram was recorded and APC PCI, Troponin I and Creatine kinase-MB concentrations were repeatedly measured 3 times at 6 h interval. Results: The 74 patients who were eventually diagnosed with myocardial infarction had a higher median level of APC-PCI complex than those Without myocardial damage; 0.27 vs. 0.20 mu g/L (p = 0.001). In a multivariate regression model, APC-PCI level in the fourth quartile (> 0.32 mu g/L) independently predicted myocardial infarction with an odds ratio of 3.7 (95% CI 1.4-9.6, p < 0.01). Conclusion: Early APC-PCI elevation can be detected among patients with a normal first Troponin I and non-ST-elevation myocardial infarction and provides additional risk assessment in acute coronary syndrome. (c) 2005 Published by Elsevier Ltd. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
protein C inhibitor, myocardial infarction, coagulation activity, activated protein C
in
Thrombosis Research
volume
118
issue
Aug 10
pages
213 - 219
publisher
Elsevier Ltd
external identifiers
  • pmid:16098566
  • wos:000238790800007
  • scopus:33744533523
  • pmid:16098566
ISSN
1879-2472
DOI
10.1016/j.thromres.2005.06.020
language
English
LU publication?
yes
id
11a3db3f-b08f-4c45-8f89-910c66f56bc5 (old id 142799)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16098566&dopt=Abstract
date added to LUP
2016-04-01 11:56:10
date last changed
2021-02-17 04:49:29
@article{11a3db3f-b08f-4c45-8f89-910c66f56bc5,
  abstract     = {Introduction: Increased coagulation activity due to coronary thrombosis in a ruptured plaque should result in activation of the protein C anticoagulant system with formation of complexes between activated protein C (APC) and,the protein C inhibitor (PCI), which reflects coagulation activity. We hypothesized that elevated APC-PCI concentration might allow earlier detection of ongoing myocardial infarction than traditional biochemical markers. We have evaluated a newly devised immunofluorimetric assay for measuring plasma concentration of APC-PCI complexes among patients with suspected acute coronary syndrome. Materials and methods: Blood samples were taken from 340 patients (median 71 years, range 31-97) with suspected acute coronary syndrome at first presentation in the emergency department. Electrocardiogram was recorded and APC PCI, Troponin I and Creatine kinase-MB concentrations were repeatedly measured 3 times at 6 h interval. Results: The 74 patients who were eventually diagnosed with myocardial infarction had a higher median level of APC-PCI complex than those Without myocardial damage; 0.27 vs. 0.20 mu g/L (p = 0.001). In a multivariate regression model, APC-PCI level in the fourth quartile (&gt; 0.32 mu g/L) independently predicted myocardial infarction with an odds ratio of 3.7 (95% CI 1.4-9.6, p &lt; 0.01). Conclusion: Early APC-PCI elevation can be detected among patients with a normal first Troponin I and non-ST-elevation myocardial infarction and provides additional risk assessment in acute coronary syndrome. (c) 2005 Published by Elsevier Ltd.},
  author       = {Bhiladvala, Pallonji and Strandberg, Karin and Stenflo, Johan and Holm, Johan},
  issn         = {1879-2472},
  language     = {eng},
  number       = {Aug 10},
  pages        = {213--219},
  publisher    = {Elsevier Ltd},
  series       = {Thrombosis Research},
  title        = {Early identification of acute myocardial infarction by activated protein C-protein C inhibitor complex.},
  url          = {http://dx.doi.org/10.1016/j.thromres.2005.06.020},
  doi          = {10.1016/j.thromres.2005.06.020},
  volume       = {118},
  year         = {2006},
}