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Title: Circulating Thrombotic Risk Factors in Young Patients with Coronary Artery Disease Who Are on Statins and Antiplatelet Drugs
Authors: Reema, G
Harikrishnan, S
Jayakumari, N
Anugya, B
Jissa, VT
Tharakan, JA
Keywords: Coronary artery disease (CAD) Premature CAD Thrombotic factors India I
Issue Date: Feb-2016
Publisher: Ind J Clin Biochem
Citation: Reema G, Harikrishnan S, Jayakumari N, Anugya B, Jissa VT, Tharakan JA . Circulating Thrombotic Risk Factors in Young Patients with Coronary Artery Disease Who Are on Statins and Antiplatelet Drugs. Ind J Clin Biochem. 2016
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 antiplatelet drugs. 152 patients (B55 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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