Long-term prognostic value of protein C activity, erythrocyte aggregation and membrane fluidity in transmural myocardial infarction

Summary

The objective of this study was to evaluate the long-term predictive value of the haemostatic,inflammatory and haemorheologic disturbances in transmural myocardial infarction (MI). Sixty-four (59 male) consecutive survivors of a MI, with a mean age of 58.3 ± 12.0 years, were followed over a period of 36 months. Eighteen patients had a cardiovascular event defined as the composite of death, non-fatal MI, unstable angina and stroke. The haemostatic (protein C activity-PtC, antithrombin III, plasminogen activator inhibitor-1), haemorheologic (blood fluidity and components, erythrocyte membrane fluidity) and inflammatory (polymorphonuclear elastase, leukocyte count) profiles were determined at hospital discharge, using standard methodology. Our results can be summarized as follow: (i) at hospital discharge, the subgroup of patients with events had higher leuko-cyte count (7833.0 ± 1696.0 vs. 10294.0 ± 3129.0; p= 0.011), lower PtC (100.65 ± 19.08 vs.81.25 ± 19.95;p = 0.002),and lower erythrocyte aggregation (14.26 ± 5.94 vs.11.47 ± 3.45;p = 0.031) in relation to the ones without events;(ii) By Cox regression the protein C activity lower tertile (OR 0.169; 0.045 – 0.628; p=0.008); erythrocyte membrane outer layer fluidity upper tertile (OR 0.067; 95% CI 0.011 – 0.393; p=0.003); and erythrocyte aggregation lower tertile (OR 0.182; 0.038 – 0.876; p= 0.034) were independent predictors of the composite endpoint. We can conclude that some haemostatic, haemorheologic and inflammatory disturbances,at hospital discharge,are long-term independent predictors of recurrent cardiovascular events in transmural myocardial infarction survivors.

Keywords

Acute myocardial infarction - erythrocyte aggregation - protein C activity - leukocyte count - membrane fluidity - prognosis

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