on August 17, 2006
Published online before print August 17, 2006, doi: 10.1161/01.ATV.0000241589.52950.4c
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Submitted on March 13, 2006
Accepted on July 21, 2006
Altered Fibrin Architecture Is Associated With Hypofibrinolysis and Premature Coronary Atherothrombosis
J. P. Collet *;
From the Departments of Cardiology (J.-P.C., Y.A., J.S., B.B., R.D., J.G., L.P., G.M.) and Haematology (C.L., A.A.), Pitié-Salpêtrière University Hospital, Paris, France; and Department of Cell & Developmental Biology (J.-P.C., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia.
* To whom correspondence should be addressed. E-mail: jean-philippe.collet{at}psl.aphp.fr.
Objective--Hypofibrinolysis promotes atherosclerosis progression and recurrent ischemic events in premature coronary artery disease. We investigated the role of fibrin physical properties in this particular setting.
Methods and Results--Biomarkers of recurrent thrombosis and premature coronary artery disease (CAD) were measured in 33 young post-myocardial infarction patients with angiographic-proven CAD and in 33 healthy volunteers matched for age and sex. Ex vivo plasma fibrin physical properties were assessed by measuring fibrin rigidity and fibrin morphological properties using a torsion pendulum and optical confocal microscopy. The fibrinolysis rate was derived from continuous monitoring of the viscoelastic properties after addition of lytic enzymes. Young CAD patients had a significant increase in plasma concentration of fibrinogen, von Willebrand factor, plasminogen activator inhibitor type 1, and lipoprotein(a) as compared with controls (P<0.05). Fibrin of young CAD patients was stiffer (P=0.002), made of numerous (P=0.002) and shorter fibers (P=0.04), and lysed at a slower rate than that of controls (P=0.03). Fibrin stiffness was an independent predictor for both premature CAD and hypofibrinolysis.
Conclusions--This first detailed study of clot properties in such a group of patients demonstrated that abnormal plasma fibrin architecture is an important feature of both premature CAD and fibrinolysis rate. The determinants of this particular phenotype warrant further investigation.
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