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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:2800.)
© 2006 American Heart Association, Inc.

Thrombosis

Tissue Factor and Coagulation Factor VII Levels During Acute Myocardial Infarction

Association With Genotype and Adverse Events

Gianluca Campo; Marco Valgimigli; Paolo Ferraresi; Patrizia Malagutti; Marcello Baroni; Chiara Arcozzi; Donato Gemmati; Gianfranco Percoco; Giovanni Parrinello; Roberto Ferrari; Francesco Bernardi

From the Department of Cardiology (G.C., M.V., P.M., G.P., R.F.), University of Ferrara, and Cardiovascular Research Center, Salvatore Maugeri Foundation, IRCCS, Gussago (Brescia); the Department of Biochemistry and Molecular Biology (P.F., M.B., F.B.), University of Ferrara; the Department of Biomedical Sciences and Advanced Therapies (D.G.), Center Study Haemostasis and Thrombosis, University of Ferrara; and the Medical Statistics Unit (G.P.), University of Brescia, Italy.

Correspondence to Marco Valgimigli, MD, Chair of Cardiology, University of Ferrara, Arcispedale S. Anna, C.so Giovecca 203, 44100 Ferrara, Italy. E-mail vlgmrc{at}unife.it

Objective— We investigated in patients with ongoing myocardial infarction (MI) whether coagulation factor VII (FVII) and tissue factor (TF) levels are affected at admission by genetic components and whether they may predict subsequent cardiovascular events.

Methods and Results— 256 patients admitted for MI were evaluated for FVII and TF antigen levels before any treatment at entry, and were genotyped for FVII and TF polymorphisms. FVII gene insertions at –323, 11293 and the –402G/A change predicted FVII levels and explained 14% of variance. The –603 TF gene polymorphism failed to affect significantly TF levels (P=0.07). These variables were correlated with the incidence of death (36 patients) and reinfarction (9 patients) after a median follow-up of 397 days. Events were independently predicted by FVII (HR 2.1, 95% CI 1.2 to 5.7) and TF (HR 4.1, 95% CI 2 to 11) levels. Composite end point was significantly worse when both parameters were above the receiver-operating characteristics (ROC) values (HR 8.3, 95% CI 5 to 18, compared with FVII and TF below), and above the ROC value of TF (>630 pg/mL) it differed among FVII genotype groups.

Conclusions— Admission FVII and TF antigen levels, partially predicted by polymorphisms, are independent predictors of mortality and reinfarction in patients with acute MI.

Admission FVII and TF antigen, partially predicted by polymorphisms, were independent predictors of composite end point (mortality and reinfarction), which was even worse in patients showing both parameters simultaneously elevated. FVII genotype influenced outcome only in patients with high TF values.

Key Words: myocardial infarction • tissue factor • factor VII • polymorphism • prognosis

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