Assessment of hemostatic risk factors in predicting arterial thrombotic events

被引:96
作者
Feinbloom, D
Bauer, KA
机构
[1] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, VA Boston Healthcare Syst, Boston, MA USA
关键词
arterial; thrombosis; atherosclerosis; hemostasis; risk factors;
D O I
10.1161/01.ATV.0000181762.31694.da
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Arterial thrombosis results from endovascular injury and, to a lesser extent, alterations in hemostatic equilibrium. Although multiple hereditary and acquired hemostatic risk factors have been described in the pathophysiology of venous thrombosis, the degree and type of abnormalities that contribute to arterial thrombosis are less well understood. Endothelial cell injury with the elaboration of proinflammatory mediators stimulates the process of arterial thrombosis. Although this is most often the result of endovascular injury attributable to atherosclerotic disease, other disease states can elicit a similar response as well. Similarly, once thrombosis has been initiated, variations in the activity of coagulation proteins and endogenous anticoagulants, as well as the kinetics of platelet aggregation, may alter the effectiveness of thrombus formation. Epidemiological studies have identified several acquired or inherited states that may result in endothelial damage or altered hemostatic equilibrium, thereby predisposing patients to arterial thrombosis. These include hyperhomocysteinemia, elevated C-reactive protein, antiphospholipid antibodies, elevated fibrinogen, Factor VII, plasminogen activator inhibitor-1 (PAI-1), hereditary thrombophilias, and platelet hyper-reactivity. This review explores our present understanding of these risk factors in the development of arterial thrombotic events. At present, the literature supports a role for hyperhomocysteinemia, elevated C-reactive protein, and elevated fibrinogen as risk factors for arterial thrombosis. Similarly, the literature suggests that lupus anticoagulants and, to a lesser extent, elevated titers of cardiolipin IgG antibodies predispose to arterial vascular events. In certain subsets of patients, including those with concomitant cardiac risk factors, < 55 years of age, and women, hereditary thrombophilias such as carriership of the factor V Leiden and the prothrombin G20210A mutations may confer a higher risk of arterial thrombosis. However, the data on Factor VII, PAI-1, and platelet receptor polymorphisms are contradictory or lacking.
引用
收藏
页码:2043 / 2053
页数:11
相关论文
共 128 条
  • [51] Jacques PF, 2001, AM J CLIN NUTR, V73, P613
  • [52] C-reactive protein: Risk marker or mediator in atherothrombosis?
    Jialal, I
    Devaraj, S
    Venugopal, SK
    [J]. HYPERTENSION, 2004, 44 (01) : 6 - 11
  • [53] Plasminogen activator inhibitor-1, inflammation, obesity, insulin resistance and vascular risk
    Juhan-Vague, I
    Alessi, MC
    Mavri, A
    Morange, PE
    [J]. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2003, 1 (07) : 1575 - 1579
  • [54] Fibrinolytic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris
    JuhanVague, I
    Pyke, SDM
    Alessi, MC
    Jespersen, J
    Haverkate, F
    Thompson, SG
    [J]. CIRCULATION, 1996, 94 (09) : 2057 - 2063
  • [55] Coagulation factor VII and the risk of coronary heart disease in healthy men
    Junker, R
    Heinrich, J
    Schulte, H
    vandeLoo, J
    Assmann, G
    [J]. ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 1997, 17 (08) : 1539 - 1544
  • [56] Homocysteine, MTHFR 677C→T polymorphism, and risk of ischemic stroke -: Results of a meta-analysis
    Kelly, PJ
    Rosand, J
    Kistler, JP
    Shih, VE
    Silveira, S
    Plomaritoglou, A
    Furie, KL
    [J]. NEUROLOGY, 2002, 59 (04) : 529 - 536
  • [57] Association between factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations and events of the arterial circulatory system: A meta-analysis of published studies
    Kim, RJ
    Becker, RC
    [J]. AMERICAN HEART JOURNAL, 2003, 146 (06) : 948 - 957
  • [58] MTHFR 677C→T polymorphism and risk of coronary heart disease -: A meta-analysis
    Klerk, M
    Verhoef, P
    Clarke, R
    Blom, HJ
    Kok, FJ
    Schouten, EG
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (16): : 2023 - 2031
  • [59] Mechanisms of disease: Plasminogen-activator inhibitor type 1 and coronary artery disease.
    Kohler, HP
    Grant, PJ
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (24) : 1792 - 1801
  • [60] Relationship between antiphospholipid antibodies and progression of lower extremity arterial occlusive disease after lower extremity bypass operations
    Lam, EY
    Taylor, LM
    Landry, GJ
    Porter, JM
    Moneta, GL
    [J]. JOURNAL OF VASCULAR SURGERY, 2001, 33 (05) : 976 - 982