We determined the plasma levels of
prothrombin fragment F1+2,
thrombin-
antithrombin III complexes (TAT),
fibrin monomers (FM), D-dimers (DD) and
fibrinogen in 57 patients with angiographically verified graded
coronary artery disease (CAD) free of concomitant peripheral
atherosclerosis,
cerebrovascular disease or
diabetes mellitus and a group of 21 apparently healthy controls. Blood was collected from the antecubital vein through atraumatic venipuncture prior to the angiographic procedure. Plasma levels of
hemostatic markers were related to the presence and graded severity of CAD. The levels of
prothrombin fragment F1+2 (1.74+/-0.11 vs. 1.0+/-0.07 nmol/l, P<0.001), FM (41.6+/-5.5 vs. 7.42+/-3.05 nmol/l, P<0.001), TAT (15.6+/-2.7 vs. 2.96+/-0.32 microg/l, P<0.001) and
fibrinogen (3.64+/-1.3 vs. 3.08+/-0.33 g/l, P<0.01) were significantly higher in patients with CAD compared to controls, while there was no difference regarding the fibrinolytic system represented by DD (441.6+/-58.9 vs. 337.4+/-42.05 microg/l, n.s.). Within the CAD group, patients with extensive
coronary atherosclerosis (> or =2 vessel disease) had significantly higher values for
prothrombin fragment F1+2 (1.89 vs. 1.57 nmol/l, P = 0.04), FM (50.7 vs. 29.8 nmol/l, P = 0.03), and a trend to significance was noted for
fibrinogen (3.9 vs. 3.3 g/l, P = 0.07) suggesting that blood coagulability was related to the severity of the disease and that
hemostatic markers of
thrombin activity represent a useful tool to identify patients with a latent hypercoagulable state with a higher susceptibility to sustain
coronary thrombosis.