Clinical Significance of Thrombosis-Related Markers in Ischemic Heart Disease

The D-dimer, plasmin-α2 plasmin inhibitor complex (PIC), plasminogen activator inhibitor-1 antigen (PAI-1 Ag) and thrombin-antithrombin III complex (TAT) in plasma were studied by enzyme immunoassay in 96 patients with ischemic heart disease (IHD), 114 young normal volunteers (mean age 30) and 72 aged normal controls (mean age 70).All patients underwent coronary artery angiography for evaluation of coronary arterial disease.D-dimer, PIC and TAT concentrations were higher in the aged controls than in young normal volunteers. PAI-1 Ag in the two groups was the same. D-dimer (161.64±116.40ng/ml), PAI-1 Ag (77.93±45.82ng/l) and TAT (4.19±4.53ng/l) concentrations were higher in patients with IHD (p<0.05, 0.005 and 0.01 respectively) than in the aged controls. PIC in the patients and aged normal controls was the same.D-dimer concentrations were remarkably higher in 61 patients (174.76±122.85ng/ml) with angiographically positive findings (luminal diameter reduction greater than 75%) than in 18 patients (109.35±62.24ng/ml) with negative findings (p<0.01). A marketly higher proportion of patients (28/29) with higher D-dimer concentration than patients (33/50) with lower D-dimer concentration had positive coronary angiography (X2=7.115, p<0.01).No remarkable differences in TAT, PIC and PAI-1 Ag could be found in patients with angiographically positive and negative findings.Increase in D-dimer, TAT and PAI-1 Ag concentrations would thus appear to be associated with increased risk of coronary thrombosis, and particularly increase in the D-dimer with the severity of coronary atherosclerosis.