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Circulating Thrombotic Risk Factors in Young Patients with Coronary Artery Disease Who Are on Statins and Anti-platelet Drugs

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Abstract

Thrombotic risk factors may contribute to premature coronary artery disease (CAD), in addition to the conventional risk factors. There is paucity of data on studies evaluating the role of thrombotic factors in premature CAD in Indian patients. Thus a case–control study was performed to evaluate the role of thrombotic and atherogenic factors in young patients with angiographically proven CAD who are on treatment with statins and anti-platelet drugs. 152 patients (≤55 years) with angiographically proven CAD and 102 asymptomatic controls were recruited. Clinical and biochemical data were obtained in both groups. Blood levels of thrombotic factors-fibrinogen, antithrombin-III, tissue-plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), von-Willebrand factor (v-WF), lipoprotein(a) [Lp(a)] and homocysteine were analyzed. Patients had high levels of conventional CAD risk factors (diabetes mellitus, smoking, hypertension, dyslipidemia and positive family history) compared to controls. Logistic regression analysis revealed that low antithrombin-III (odds ratio/OR 11.2; 95 % confidence interval/CI 2.29–54.01), high fibrinogen (OR 6.04; 95 % CI 1.09–33.21) and high Lp(a) (OR 4.54; 95 % CI 0.92–22.56), as important, independent risk factors in patients. PAI-1(OR 0.15; 95 % CI 0.03–0.69) levels were significantly lower in patients. But other thrombotic risk factors studied (t-PA, v-WF and homocysteine) were comparable among patients and controls. The treatment using statins and anti-platelet drugs might be contributing to the control of some of the thrombotic risk factors. The strategies aiming at lowering the levels of thrombotic risk factors along with conventional risk factors may be useful in primary and secondary prevention of CAD.

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Acknowledgments

All authors wish to acknowledge the grant provided by Kerala State Council for Science, Technology and Environment, Pattom P.O. Thiruvananthapuram, Kerala, India (FILE No.: 041/SRSLS/07/CSTE). Authors also acknowledge the Junior Research Fellowship and Senior Research Fellowship provided to Ms Reema George by Council of Scientific and Industrial Research, Pusa, New Delhi, Pin: 110001(File No.: 09/523(0075)/2011-EMR-I). Authors wish to thank Dr Lissy K Krishnan and all staff of Thrombosis Research Unit (SCTIMST), for providing facilities for conduct of experiments related to thrombotic risk factors. Help rendered by all staffs of Central Clinical Lab- Department of Biochemistry and Department of Cardiology (SCTIMST) is also acknowledged. Facilities provided by Advanced Clinical Research (ACR) Lab, Kerala Health Research Welfare Society, Medical College, Thiruvananthapuram are also acknowledged. Authors also thank the effort of Manas Chacko, Krishna Sankar and Anand for the help rendered in collection of samples and data.

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Authors and Affiliations

  1. Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, 695011, Kerala, India

    Reema George, Harikrishnan Sivadasanpillai & Jaganmohan A. Tharakan

  2. Department of Biochemistry, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, 695011, Kerala, India

    Narayani Jayakumari

  3. Thrombosis Research Unit, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Poojapura, 695012, Kerala, India

    Anugya Bhatt

  4. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, 695011, Kerala, India

    Jissa V. Thulaseedharan

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  1. Reema George
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Correspondence to Harikrishnan Sivadasanpillai.

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George, R., Sivadasanpillai, H., Jayakumari, N. et al. Circulating Thrombotic Risk Factors in Young Patients with Coronary Artery Disease Who Are on Statins and Anti-platelet Drugs. Ind J Clin Biochem 31, 302–309 (2016). https://doi.org/10.1007/s12291-015-0540-y

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  • DOI: https://doi.org/10.1007/s12291-015-0540-y

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