22. Joint effect of acute myocardial infarction on lipoprotein(a), C- reactive protein and markers of haemostasis

Abstract

Objectives An issue of considerable interest is the relative contribution of each component of atherogenesis to CAD risk. An integrated approach encompassing the relationship between non traditional risk factors and coagulation assembly needs further studies.This study aimed at an integrated approach to study the joint changes in lipoprotein(a) [Lp(a)], high sensitivity C-reactive-protein (hsCRP) and haemostatic parameters in patients with acute myocardial infarction(AMI) and their correlation with clinical characteristics in these patients. Methods This study was conducted at the departments of physiology, emergency medicine and cardiology. Serial blood samples were collected from 50 patients with AMI on admission to the hospital (1st sample), after 3–4days (post revascularization, 2nd sample) and at 2–3months of follow up (3rd sample) and control group of 22 healthy subjects. The relationship of these markers were also studied with the presence and severity of CAD assessed by vessel and Gensini scoring. Blood samples were analyzed for lipids, Lp(a), hsCRP, fibrinogen, total(TFPI-T) & free(TFPI-F) tissue factor pathway inhibitor, plasminogen activator inhibitor-1 (PAI-1), and tissue-plasminogen-activator (t-PA). Results Lp(a), hsCRP, fibrinogen, PAI-1, TFPI-T and TFPI-F were significantly higher in AMI compared to control subjects. Lp(a) significantly increased in 2nd sample by 19.5% ( P P Conclusions Acute myocardial infarction affects Lp(a), hsCRP and hemostatic markers significantly. Lp(a), hsCRP and TFPI-T related significantly to CAD severity. While fibrinogen, PAI-1 and TFPI-F were related to the presence of CAD but there was no relationship with its severity.