Predictive value of hemostatic factors for sudden death in patients with stable angina pectoris

To assess hemostatic risk factors for sudden death in patients with stable angina, 323 consecutive patients were recruited prospectively. Patients with clinical heart failure or recent myocardial infarction were excluded. The following clinical variables were recorded: age, gender, smoking habits, h...

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Veröffentlicht in:The American journal of cardiology 1995-08, Vol.76 (4), p.241-244
Hauptverfasser: Benchimol, Daniel, Dartiques, Jean-François, Benchimol, He´le`ne, Drouillet, Françoise, Lauribe, Philippe, Marazanof, Marc, Couffinhal, Thierry, Bonnet, Jacques
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container_end_page 244
container_issue 4
container_start_page 241
container_title The American journal of cardiology
container_volume 76
creator Benchimol, Daniel
Dartiques, Jean-François
Benchimol, He´le`ne
Drouillet, Françoise
Lauribe, Philippe
Marazanof, Marc
Couffinhal, Thierry
Bonnet, Jacques
description To assess hemostatic risk factors for sudden death in patients with stable angina, 323 consecutive patients were recruited prospectively. Patients with clinical heart failure or recent myocardial infarction were excluded. The following clinical variables were recorded: age, gender, smoking habits, hypertension, previous myocardial infarction, left ventricular hypertrophy, and severe ventricular arrhythmia. Angiographic variables included coronary extent, assessed from Jenkins' and mean atherosclerotic scores, and left ventricular ejection fraction. Lipid variables included total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoproteins A-I and B. Hemostatic factors included fibrinogen, fibrinopeptide A, antithrombin III, factor VIII antigen, factor VIII coagulant, protein C, plasminogen, α2 antiplasmin, euglobulin clot lysis time, tissue plasminogen activator before and after venous occlusion, and plasminogen activator inhibitor. There were 34 deaths, 19 of which were sudden during the follow-up period (60 ± 17 months). The association between each variable and the risk of sudden death was assessed by calculating the relative risk with the Cox univariate model. All significant predictors from the univariate analysis were then incorporated in a Cox multivariate model to select the independent predictors of sudden death. The inderpendent predictors of sudden death were left ventricular hypertrophy (p
doi_str_mv 10.1016/S0002-9149(99)80073-3
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Patients with clinical heart failure or recent myocardial infarction were excluded. The following clinical variables were recorded: age, gender, smoking habits, hypertension, previous myocardial infarction, left ventricular hypertrophy, and severe ventricular arrhythmia. Angiographic variables included coronary extent, assessed from Jenkins' and mean atherosclerotic scores, and left ventricular ejection fraction. Lipid variables included total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoproteins A-I and B. Hemostatic factors included fibrinogen, fibrinopeptide A, antithrombin III, factor VIII antigen, factor VIII coagulant, protein C, plasminogen, α2 antiplasmin, euglobulin clot lysis time, tissue plasminogen activator before and after venous occlusion, and plasminogen activator inhibitor. There were 34 deaths, 19 of which were sudden during the follow-up period (60 ± 17 months). The association between each variable and the risk of sudden death was assessed by calculating the relative risk with the Cox univariate model. All significant predictors from the univariate analysis were then incorporated in a Cox multivariate model to select the independent predictors of sudden death. The inderpendent predictors of sudden death were left ventricular hypertrophy (p &lt;0.04), lower left ventricular election fraction (p &lt;0.04), and shorter euglobulin clot lysis time after venous occlusion (p &lt;0.02), whereas fibrinogen (p &lt;0.07) and Jenkins' score (p &lt;0.08) were borderline. 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Patients with clinical heart failure or recent myocardial infarction were excluded. The following clinical variables were recorded: age, gender, smoking habits, hypertension, previous myocardial infarction, left ventricular hypertrophy, and severe ventricular arrhythmia. Angiographic variables included coronary extent, assessed from Jenkins' and mean atherosclerotic scores, and left ventricular ejection fraction. Lipid variables included total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoproteins A-I and B. Hemostatic factors included fibrinogen, fibrinopeptide A, antithrombin III, factor VIII antigen, factor VIII coagulant, protein C, plasminogen, α2 antiplasmin, euglobulin clot lysis time, tissue plasminogen activator before and after venous occlusion, and plasminogen activator inhibitor. There were 34 deaths, 19 of which were sudden during the follow-up period (60 ± 17 months). The association between each variable and the risk of sudden death was assessed by calculating the relative risk with the Cox univariate model. All significant predictors from the univariate analysis were then incorporated in a Cox multivariate model to select the independent predictors of sudden death. The inderpendent predictors of sudden death were left ventricular hypertrophy (p &lt;0.04), lower left ventricular election fraction (p &lt;0.04), and shorter euglobulin clot lysis time after venous occlusion (p &lt;0.02), whereas fibrinogen (p &lt;0.07) and Jenkins' score (p &lt;0.08) were borderline. Determination of hemostatic variables, especially those pertaining to dynamic fibrinolysis, may thus be of value in assessing risk of sudden death.</description><subject>Analysis of Variance</subject><subject>Angina pectoris</subject><subject>Angina Pectoris - blood</subject><subject>Angina Pectoris - complications</subject><subject>Angina Pectoris - physiopathology</subject><subject>Anticoagulants - analysis</subject><subject>Biological and medical sciences</subject><subject>Blood Coagulation Factors - analysis</subject><subject>Cardiology. 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Patients with clinical heart failure or recent myocardial infarction were excluded. The following clinical variables were recorded: age, gender, smoking habits, hypertension, previous myocardial infarction, left ventricular hypertrophy, and severe ventricular arrhythmia. Angiographic variables included coronary extent, assessed from Jenkins' and mean atherosclerotic scores, and left ventricular ejection fraction. Lipid variables included total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoproteins A-I and B. Hemostatic factors included fibrinogen, fibrinopeptide A, antithrombin III, factor VIII antigen, factor VIII coagulant, protein C, plasminogen, α2 antiplasmin, euglobulin clot lysis time, tissue plasminogen activator before and after venous occlusion, and plasminogen activator inhibitor. There were 34 deaths, 19 of which were sudden during the follow-up period (60 ± 17 months). The association between each variable and the risk of sudden death was assessed by calculating the relative risk with the Cox univariate model. All significant predictors from the univariate analysis were then incorporated in a Cox multivariate model to select the independent predictors of sudden death. The inderpendent predictors of sudden death were left ventricular hypertrophy (p &lt;0.04), lower left ventricular election fraction (p &lt;0.04), and shorter euglobulin clot lysis time after venous occlusion (p &lt;0.02), whereas fibrinogen (p &lt;0.07) and Jenkins' score (p &lt;0.08) were borderline. Determination of hemostatic variables, especially those pertaining to dynamic fibrinolysis, may thus be of value in assessing risk of sudden death.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7618616</pmid><doi>10.1016/S0002-9149(99)80073-3</doi><tpages>4</tpages></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals
subjects Analysis of Variance
Angina pectoris
Angina Pectoris - blood
Angina Pectoris - complications
Angina Pectoris - physiopathology
Anticoagulants - analysis
Biological and medical sciences
Blood Coagulation Factors - analysis
Cardiology. Vascular system
Coronary heart disease
Coronary vessels
Death, Sudden - etiology
Fatalities
Female
Heart
Humans
Lipids - blood
Male
Medical research
Medical sciences
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Risk Factors
title Predictive value of hemostatic factors for sudden death in patients with stable angina pectoris
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