Characteristics of Vasospastic Angina With Exercised-Induced Ischemia : Analysis of Parameters of Hemostasis and Fibrinolysis

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To characterize the vasospastic angina patients with exercise-induced ischemia, we measured hemostasis(platelet factor 4; PF4, fibrinopeptide A; FPA)and fibrinolytic parameters(tissue plasminogen activator antigen; t-PA, free plas-minogen activator inhibitor-1 antigen; free PAI-1)in 15 normal subjects and 33 vasospastic angina patients without significant coronary artery stenosis(less than 50% stenosis). All of the vasospastic angina patients began to feel chest pain within 3 months before diagnostic coronary angiography. Blood samples were obtained from all of the study patients at 8:30-9:30 am before exercise ^<201>T1 emission computed tomography. Vasospastic angina patients were divided into 2 groups; 15 patients with exercise-induced ischemia(group 1)and 18 patients without exercise-induced ischemia(group 2). On coronary angiography, the severity of coronary artery stenosis at the site of spasm in group 1(34±5%)was greater than that in group 2(18±3%). Plasma FPA and PF 4 levels in group 1 were also significantly higher than those in normal subjects and group 2. Plasma t-PA and free PAI-1 levels in group 1 were significantly higher than those in normal subjects and group 2. Plasma levels of free PAI-1 in group 2 were also significantly higher than those in normal subjects. The present study demonstrated that all of the patients with vasospastic angina had impaired fibrinolysis, and these patients with exercise-induced ischemia showed enhanced platelet activation, an enhanced coagulation system, and advanced atherosclerotic lesions. These results suggest that vasospastic angina with exerciseinduced ischemia puts patients at increased risk for thrombus formation.
社団法人日本循環器学会の論文
1996-04-20

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