[The prognostic significance of hemostatic system factors in patients with ischemic heart disease].

The study was undertaken to elucidate the role of hemostatic parameters versus clinical data in the development of myocardial infarction and cardiac death. A total of 56 patients who suffered from angiographically documented coronary heart disease were examined. In addition to coronary angiography, bicycle ergometry, blood lipid measurements performed, the authors measured the levels of fibrinogen (FG), C protein, plasminogen, antiplasmin, fibrinogen/fibrin degradation products, tissue plasminogen activator (TPA) in venous occlusion, its inhibitor. The follow-up averaged 718 +/- 32.4 days. Nine patients developed large myocardial infarction, 6 died. In patients with poor prognosis, the baseline levels of FG and TPA were significantly higher: 3.35 +/- 0.168 and 2.73 +/- 0.79 g/l (P = 0.007) and 129.3 +/- 67.8 +/- 6.5 IU/ml (p = 0.049), respectively. A multifactorial discriminant analysis showed that TPA was the first to be of prognostic value in predicting the unfavourable prognosis, whereas FG and the number of coronary arteries with more than 70% narrowing and cholesterol levels were the second, third, and fourth. Thus, it was found that in addition to the levels of cholesterol and the number of diseased coronary arteries, the levels of TPA and FG appeared to be the most significant determinants of a patient's prognosis.