1999, Number 3
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Rev Mex Patol Clin Med Lab 1999; 46 (3)
Antithrombin III in non insulin dependent diabetes mellitus of patients with myocardial infarction
Reyes RGL, Mansilla OA, García ERM, Poblete PTJ, Gutiérrez GJN, Navarro RJ, Jiménez VM
Language: Spanish
References: 37
Page: 159-165
PDF size: 195.01 Kb.
ABSTRACT
Objective: To determine whether a relationship exists between antithrombin III (ATIII) levels and miocardial infarct (MI) by coronary thrombosis in the non-insulin-dependent diabetic patient.
Materials and methods: A descriptive study of 99 non-insulin-dependent patients was carried out. Plasmatic levels of ATIII were measured. Group I included patients with MI on whom coronary angiography had been previously performed. Group II was made up of 32 patients with non-insulin-dependent diabetes mellitus (NIDDM) without miocardial infarct.
Results: Group I was composed of 42 males (63%) and 25 females (37%) patients. The age interval of the group studied ranged from 42-82 years. On determination of ATIII levels, 50 (75%) were found in reference numbers (88-131%) and 17 (25%) with diminution. Forty-five patients exhibited a coronary obstruction level greater or equal to 85%. In 34 (50.7%) patients, the ATIII value was found in reference values, and in 11 (16.4%) of the patients, diminution was found (40-83%).
Among the 22 patients with an obstruction grade of less or equal to 84% 16 (24%) presented normal activity, and six patients (9%) showed diminution. Additionally, the MI evolution interval ranged from 6-60 hours, noting that from 36 hours, percent of ATIII activity was diminished (40-83%). In group II, the percent of ATIII activity was found in the reference values, with a range of 88-115%.
Conclusions: ATIII activity is not altered during the first 24 hours of MI. Although this study was not designed to evaluate MI evolution, we observed a correlation between MI evolution and diminution in ATIII activity.
REFERENCES
Hughes A, McVerry BA, Wilkinson L, Goldstone AH, Lewis D. Diabetes: a hypercoagulable state? Haemostatic variables in newly diagnosed type 2 diabetic patients. Acta haematol 1983; 69:254-259.
National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979; 28:1039-1057.
Jarrett RJ. Epidemiology and public health aspects of non-insulin-dependent diabetes mellitus. Epidemiol Rev 1989; 11:151-71.
Lowe GDO, Tromberg P, MC Ardle BM, Lorimer AR, Forbes CD. Increased blood viscosity and fibrinolytic inhibitor in type II hiperlipoproteinaemia. Lancet 1982; 27:472-75.
Davies MJ, Thomas AC. Thrombosis and acute coronary lesions in sudden cardiac ischemic death. N Engl J Med 1984; 310:1137-1140.
Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. N Engl J Med 1992; 326:310-318.
Fuster V, Badimon J, Badimon L, Chesebro J. The pathogenesis of coronary artery disease and the acute coronary syndromes, II. N Engl J Med 1993; 325:410-418.
Fuster V, Stein B, Ambrose J, Badimon L, Badimon J, Chesebro J. Atherosclerotic plaque rupture and thrombosis: evolving concepts. Circulation 1990; 82: 1147-1159.
Russell PT, Bovill EG. Thrombosis and cardiovascular risk in the elderyl. Arch Pathol Lab Med 1992; 116: 1307-1312.
Boisclair MD, Lane DA, Wilde JT, Ireland H, Preston FE. A comparative evaluation of assay for markers of activated coagulation and/or fibrinolysis: thrombin-antithrombin complex, D-dimer and fibrinogen/fibrin fragment E antigen. Br J Haematol 1990; 74: 471-9.
Juhan-Vague I, Aless MC and Vague P: Thrombogenic and fibrinolytic factors and cardiovascular risk in non-insulin-dependent diabetes mellitus. Ann Med 1996; 28: 371-380.
Assman G and Schulte H. Identification of individuals at hihgrisk for miocardial infarction. Atherosclerosis 1994; 110 (Suppl): s11-s21.
Kannel W, D’Agostino, Belanger A. Fibrinogen, cigarrete smoking and risk of cardiovascular disease: Insights from the Framingham Study. American Heart Journal 1992; 113: 1006-12.
Meade T, Brozovic M, Chakrabati R, Haines A, Imeson J et al. Haemostatic function and ischaemic heart disease; principal results of the northwick park heart study. Lancet 1986; 6533-37.
Koening W, Sund M, Ernst E, Mraz W, Hombach et al. Association between rheology and components of lipoproteins in human blood. Results from MONICA project. Circulation 1992; 85: 2197-2204.
Koening W, Ernst E. The possible role of hemorrheology in atherothrombogenesis. Atherosclerosis 1992; 94: 93-107.
Dientenfass L. Blood rheology in pathogenesis of the coronary heart diseases. Am Heart J 1969; 77: 139-147.
Dientenfass L. Viscosity of blood in normal subjects and in patients suffering from coronary occlusion and arterial thrombosis. Am Heart J 1966; 71: 588-600.
Mead TW, North WRS, Chakrabarti R, Haines AP. Population-based distributions of haemostatic variables. Br Med Bull 1977; 33: 283-288.
Charlotte W, Pratt and Church F. Antithrombina: structure and function. Sem in Hematol 1991; 8(1): 3-9.
Martínez-Murillo C, Quintana GS. Manual de hemostasia y trombosis. Bases fisiopatológicas y clínicas de las enfermedades hemorrágicas y trombóticas. 1996; Ed. Prado. Mex.
Schafer AI. The hypercoagulable states. Ann Intern Med 1985; 102: 814-828.
Von Kaulla E, Von Kaulla K. Antithrombin and disease. Am J Clin Pathol 1967; 48(1): 69-80.
Kenneth A, Bauer MD. Laboratory Markers of Coagulation Activation. Arch Pathol Lab Med 1993; 117: 71-77.
Hedner U, Nilsson IM. Antithrombin III in a clinical material. Thromb Res 1973; 3: 631-641.
IL TESTTM Antithrombin III Chromogenic Substrate Assay Cat. No. 97574-15.
Compendios de ILADIBA. Infarto de miocardio: perspectivas actuales de la terapia trombolítica y antitrombótica. Cardiología 1990 II:13-15.
Fuster V. Conceptos actuales sobre la patogénesis y el manejo de los síndromes isquémicos coronarios agudos. Circulation 1988; 77:1213-1220.
Férez Santander SM, De la Peña Almaguer E. Daño miocárdico por reperfusión: su impacto en la clínica. Parte I. Arch Inst Cardiol Méx 1998; 68:431-437.
Férez Santander SM, De la Peña Almaguer E. Daño miocárdico por reperfusión: su impacto en la clínica. Parte II. Arch Inst Cardiol Méx 1998; 69:371-376.
Daviet L, McGregor JL. Vascular biology of CD36: Roles of this new adhesion molecule family in different disease states. Thromb Haemost 1997; 78: 65-9.
Gachet C, Hechler B, Leon C, Vialn C, Leray C, Ohlmann P. Activation of ADP receptors and platelet function. Thromb Haemost 1997; 78:271-5.
Giddings JC, Rails H, Davies D, Jennings G, Tanswell. Enhanced platelet sensitivity to adenosine diphosphate (ADP) in patients with cardiac valve disease. Thromb Haemost 1997; suppl 1:61.
MacFarlane RG. An enzyme cascade in the blood clotting mechanism, and its function as a biochemical amplifier. Nature 1964; 202:498.
Davie EW, and Ratnoff OD. Waterfall sequence for intrinsic blood clotting. Science 1964; 145:1310.
Kennet KW. Endothelial cells in hemostasis, thrombosis, and inflammation. Hospital Practice 1992;15:145-166.
Hedner U, Nilsson IM. Antithrombin III in a clinical material. Thromb Res 1973; 3:631-641.