Platelet-dependent thrombin generation was assessed during both unstable and stable periods in 59 patients with unstable angina and at rest in 31 healthy controls. Thrombin generation during the unstable period was significantly greater than that at rest in the healthy control group (p < 0.0001) and that during the stable period (p < 0.0001). Changes in thrombin gener ation were related to the time after onset of unstable angina, not to degree of improvement in the severity of coronary stenosis.
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References
1.
Davies MJ, Thomas AC: Plaque fissuring—the cause of acute myocardial infarction, sudden ischemic death, and crescendo angina. Br Heart J53:363-373, 1985.
2.
Fuster V., Stein B., Ambrose JA, et al: Atherosclerotic plaque rupture and thrombosis. Evolving concepts . Circulation82 (suppl II):II-47-II-59, 1990.
3.
Fuster V., Badimon JJ, Chesebro JH: The pathogenesis of coronary artery disease and the acute coronary syndromes. Part 1. N Engl J Med326:242-250, 1992.
4.
Fuster V., Badimon JJ, Chesebro JH: The pathogenesis of coronary artery disease and the acute coronary syndromes. Part 2. N Engl J Med326:310-318, 1992.
5.
Aronson DL, Chang P., Kessler CM: Platelet-dependent thrombin generation after in vitro fibrinolytic treatment . Circulation85:1706-1712, 1992 .
6.
Aoki I., Aoki N., Kawano K., et al: Platelet-dependent thrombin generation in patients with hyperlipidemia . J Am Coll Cardiol30:91-96, 1997.
7.
Aoki I., Shimoyama K., Aoki N., et al: Platelet-dependent thrombin generation in patients with diabetes mellitus: Effect of glycemic control on coagulability in diabetes. J Am Coll Cardiol27:560-566, 1996.
8.
Diego A., Piera AM, Stefano S.: Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris. J Am Coll Cardiol29:941-947, 1997.
9.
Braunwald E., Mark DB, Jones RH: Unstable angina: diagnosis and management. Clinical Practice Guideline Number 10, AHCPR Publication No 94-0602, Rockville, MD , March 1994, Agency for Health Care Policy and Research and the National, Heart, Lung and Blood Institute, Public Health Service, US Department of Health and Human Services.
10.
Braunwald E. : Unstable angina. A classification. Circulation80:410-414, 1989.
11.
World Health Organization Expert Committee. Second report on diabetes mellitus. Geneva, World Health Organization1980 (Tech. Rep. ser., no. 646).
12.
The sixth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med157 :2413-2445,1997.
13.
Theroux P., Latour JG, Leger-Gautier C., et al: Fibrinopeptide A plasma levels and platelet factor 4 levels in unstable angina pectoris. Circulation75:156-162, 1987.
14.
Merlini PA, Bauer KA, Ortrona L., et al: Persistent activations of coagulation mechanism in unstable angina and myocardial infarction. Circulation90:61-68, 1994.
15.
Cox AC, Inyangetor P., Esmon CT, et al: The effect of aggregation and release on platelet prothrombin-converting activity. Blood54:659-672, 1979.
16.
Rosing J., van Rijn Jlml, Bevers EM, et al: The role of activated human platelets in prothrombin and factor X activation. Blood65:319-332, 1985.
17.
Zwaal Rfa, Comfurius P., Bevers EM: Platelet procoagulant activity and microvesicle formation. It's putative role in hemostasis and thrombosis. Biochem Biophys Acta1180:1-8, 1992.
18.
Zijlstra F. , de Boor MJ, Hoorntje JC, et al: A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction . N Engl J Med328:680-684, 1993.
19.
Carvalho deSousa J., Azevedo J., Soria C., et al: Factor VII hyperactivity in the acute myocardial thrombosis. A relation to the coagulation activation . Thromb Res51:165-173, 1988.
20.
Zalewski A. , Shi Y., Nardone D., et al: Evidence for reduced fibrinolytic activity in unstable angina at rest. Circulation83:1685-1691, 1991.
21.
Hoffmeister HM, Jur M., Wendel HP, et al: Alterations of coagulation and fibrinolytic and Kallikrein-Kinin systems in the acute and postacute phases in patients with unstable angina pectoris. Circulation91:2520-2527, 1995.