FIBRINOPEPTIDE-A, PLATELET FACTOR-4, AND BETA-THROMBOGLOBULIN LEVELS IN CORONARY HEART-DISEASE

  • 1 January 1982
    • journal article
    • research article
    • Vol. 60  (3) , 650-654
Abstract
In vivo platelet .alpha.-granule release and fibrin I formation were measured in 82 patients with ischemic heart disease by radioimmunoassay of platelet factor 4, .beta.-thromboglobulin and fibrinopeptide A. The presence and extent of coronary artery disease were determined by coronary arteriography, and the extent of left ventricular regional dysfunction was assessed by contrast left ventriculography. In patients with abnormal coronary arteriograms without previous myocardial infarction, mean levels of platelet factor 4, .beta.-thromboglobulin and fibrinopeptide A were not elevated. In patients in whom myocardial infarction had occurred more than 6 mo. previously, platelet factor 4 (8.3 ng/ml; P < 0.01) and .beta.-thromboglobulin (33.2 ng/ml; P < 0.001) levels were significantly elevated, but fibrinopeptide A levels were normal. Levels of platelet factor 4 and .beta.-thromboglobulin were unrelated to the extent of coronary artery disease. In the patients with prior infarction, .beta.-thromboglobulin correlated directly with extent of the left ventricular regional dysfunction (r = 0.53; P < 0.01) and inversely with ejection fraction (r = -0.56; P < 0.05). In a small group of patients with left ventricular aneurysm, mean fibrinopeptide A levels were also elevated. Platelet release in patients with ischemic heart disease apparently results from platelet reaction with previously infarcted myocardium rather than with the atherosclerotic coronary arteries.