Inflammation, fibrinogen and thrombin generation in patients with previous myocardial infarction.

BACKGROUND AND OBJECTIVES It has been reported that the influence of plasma fibrinogen on the incidence of myocardial infarction is related to inflammatory processes. The aim of this study was to investigate the relationship between inflammatory activity, fibrinogen and thrombin generation in patients 5 years after the acute phase of myocardial infarction. DESIGN AND METHODS Sixty-seven patients 5 years after a myocardial infarction and 67 control subjects were studied. Plasma fibrinogen protein (Fg-protein) and function (Fg-function), prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), total sialic acid (TSA) and C-reactive protein (CRP) were measured. RESULTS The levels of Fg-protein, Fg-function, F1+2, TAT, TSA and CRP were significantly higher in patients than in the control subjects. Plasma TSA correlated with CRP (r=0.31, p<0.05). There was a significant correlation between TSA and Fg-protein or Fg-function (r=0.48, p<0.01). CRP correlated with Fg-function (r=0.32, p<0.05) while there was no correlation between CRP and Fg-protein. CRP also correlated with F1+2 and TAT (r= 0.4, p<0.01). INTERPRETATION AND CONCLUSIONS Five years after myocardial infarction there was clear evidence of low-grade inflammation that was accompanied by an increase in thrombin formation. The increase of the plasma fibrinogen level is mainly related to TSA and the increase of CRP, which is associated with thrombin generation.