Study Of Tissue Factor Pathway Inhibitor And V264M Polymorphism In Acute Coronary Syndrome

Part I Study of free tissue factor pathway inhibitor in acutecoronary syndromeBackground: Coronary artery disease is one of the main killer inmodern society and have a very intricating mechanism which have notbeen clearly yet. Recently, evidence have shown that there may be arelationship between coagulation pathway and acute coronarysyndrome(ACS).However, tissue factor pathway inhibitor(TFPI) is themost effective factor to inhibit the activity of tissue factor, accordingly ,itcan block the external coagulation pathway thoroughly. So, TFPI andACS has a closely relationship.Objectives: To assess the effect of free tissue factor pathway inhibitor(f-TFPI) on the pathogenesis of acute coronary syndrome (ACS).Methods: Using the ELISA assay to test the plasma level of f-TFPI in 57patients, including 18 normal subjects and 39 patients with ACS, thencomparing the plasma level of f-TFPI in two groups and subgroups inACS.Results: The plasma level of f-TFPI in patients with ACS wassignificantly higher than that in normal subjects.Meanwhile, the plasmalevel of f-TFPI in AMI subgroup was dramatically higher than that inunstable angina subgroup.Conclusion: f-TFPI is an predictor of coagulation secondary to injuringof endothelium in ACS patients, therefore ,it may play an important rolein the pathogenesis of ACS and could serve as an marker to pick outpatients at high risk of ACS.Part II Free tissue factor pathway inhibitor gene(V264M) polymorphisms in patients with acute coronary syndrome Background: Recently, the abnormal of coagulation have became one of the highlight in study of acute coronary syndrome. Some researcher have reported that the gene mutation of tissue factor pathway inhibitor (TFPI),especially the mutation of V264M , have an close relationship with the pathogenesis of acute coronary syndrome(ACS). Objectives: To investigate the relationship between plasma levels of free tissue factor pathway inhibitor (f-TFPI) and V264M polymorphism in patients with acute coronary syndrome (ACS) in Chinese populations. Methods: The genotypes of V264M were detected by PCR-RFLP in 136 patients with ACS and 106 control subjects undergoing coronary angiography, and the serum f-TFPI level in 57 cases were inspected by enzyme linked immunosorbent assay.Results: ACS group showed significantly higher plasma level of f-TFPI than control group(p<0.05).The frequencies of alleles and genotypes were consistent with that predicted by Hardy Weinberg equilibrium in the present study population(x2=0.437,p>0.05).There was no significant difference between ACS group and control group of V264M polymorphism(p>0.05).Plasma f-TFPI level was significantly lower in carriers of A allele as compared with non-carriers(GG genotype)[(6.9 ± 5.1)vs(14.3 ± 9.5)].There was also no significant difference in the severity...