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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1996;16:357-362.)
© 1996 American Heart Association, Inc.

Articles

Antithrombin III and Fibrinogen as Predictors of Cardiac Events in Patients With Angina Pectoris

S.G. Thompson; C. Fechtrup; E. Squire; U. Heyse; G. Breithardt; J.C.W. van de Loo; J. Kienast

From the Medical Statistics Unit (S.G.T., E.S.), London School of Hygiene and Tropical Medicine, London, UK, and the Departments of Internal Medicine (Cardiology and Angiology) and Institute for Arteriosclerosis Research (C.F., U.H., G.B.) and Internal Medicine (Haematology) (J.C.W. van de L., J.K.), University of Münster, Münster, Germany.

Correspondence to S.G. Thompson, Medical Statistics Unit, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK. E-mail sthompso@lshtm.ac.uk.

Abstract Because measurements of hemostatic factors might aid the prediction of cardiovascular clinical events, we investigated the long-term prognostic importance of selected hemostatic factors in patients with angina pectoris. At recruitment, 209 patients underwent clinical assessment and coronary angiography, and a range of hemostatic factors were measured. During the follow-up period of 9 years, 58 patients (28%) suffered a cardiac event (acute myocardial infarction or death from cardiac causes). The risk of cardiac events was positively related to baseline measurements of fibrinogen (risk ratio per SD [RR] increase 1.29, 95% confidence interval [CI] 0.99 to 1.68, P=.06) and negatively related to antithrombin III activity measurements (RR 0.75, 95% CI 0.59 to 0.95, P=.02). No other hemostatic factor measured was significantly related to the risk of having a cardiac event. Worsening of angina in the few weeks before and ejection fraction evaluation at the initial angiography were both strongly related to the risk of cardiac events. However, the relationships of fibrinogen and antithrombin III measurements to risk remained almost unchanged after adjusting for worsening of angina and ejection fraction. Fibrinogen and antithrombin III may have an important etiologic role in the prognosis of patients with angina pectoris.

Key Words: hemostatic factors • antithrombin III • fibrinogen • angina pectoris • prognosis

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