The change of clotting mechanism in patients with coronary heart disease and its clinical significance

Objectives To investigate the changes of plasma tissue factor(TF),tissue factor pathway inhibitor(TFPI),activated partial thromboplastin time(APTT) and international normalized ratio(INR) in patients with coronary heart disease(CHD) and explore their clinical significance in diagnosis and treatment of CHD.Methods Ninety-six patients with CHD were divided into three groups:acute myocardial infarction(AMI) group,unstable angina pectoris(UAP) group and stable angina pectoris(SAP) group.According to Gensini score system,they were divided into groups A,B and C.Twenty-five non-CHD patients served as control.The changes of TF,TFPI,TF/TFPI,INR and APTT in different groups were analyzed.Results The concentrations of plasma TF,TFPI and TF/TFPI were higher in the CHD group than in the control group,but the INR and APTT in the CHD group were lower.The concentrations of plasma TF,TFPI and TF/TFPI were higher in the AMI patients than in patients with UAP and SAP,while the INR and APTT were exactly the opposite.The concentrations of plasma TF and TF/TFPI were higher in group C than in group A and group B,while INR and APTT were lower in group C than in group A and group B.INR was negatively correlated with TF/TFPI(r=-0.302,P=0.003) and positively correlated with APTT(r=0.349,P=0.01).Conclusions To a certain extent,the concentrations of plasma TF,TFPI,TF/TFPI,INR and APTT in CHD group may reflect the severity of the illness,and TF/TFPI can also reflect the state of blood coagulation in CHD patients,it has certain clinical significance in risk stratification and treatment of CHD.