Download PDF
Thromb Haemost 1994; 71(05): 707-712
DOI: 10.1055/s-0038-1642509
Review Article
Schattauer GmbH Stuttgart

Relationship of Tissue Factor Pathway Inhibitor Activity to Plasma Lipoproteins and Myocardial Infarction at a Young Age

Elisabeth Moor
1   The Divisions of Cardiology, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
,
Anders Hamsten
2   Internal Medicine, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
3   The Atherosclerosis Research Unit King Gustaf V Research Institute, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
,
Fredrik Karpe
2   Internal Medicine, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
3   The Atherosclerosis Research Unit King Gustaf V Research Institute, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
,
Peter Båvenholm
2   Internal Medicine, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
3   The Atherosclerosis Research Unit King Gustaf V Research Institute, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
,
Margareta Blombäck
4   Department of Medicine, and Division of Clinical Chemistry and Blood Coagulation, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
,
Angela Silveira
3   The Atherosclerosis Research Unit King Gustaf V Research Institute, Department of Laboratory Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
› Author Affiliations
Further Information

Publication History

Received: 30 September 1993

Accepted after revision 24 February 1994

Publication Date:
06 July 2018 (online)

  PDF Download  Permissions and Reprints

Summary

Tissue factor pathway inhibitor (TFPI) activity was quantified in two cohorts of young male post-infarction patients and in population-based control subjects to explore the relationships between TFPI activity and plasma lipoproteins and to address the issue of coordinate regulation of factor VII and TFPI in hyperlipidaemia and premature coronary heart disease (CHD). Participants were investigated in the fasting state and after an oral fat load. Basal TFPI activity and factor VII antigen (VIIag) levels were found to be increased in the patients (TFPI activity 1.25 ± 0.23 vs 1.17 ± 0.20 U/ml, p <0.05; VIIag 537.7 ± 127.7 vs 479.4 ± 93.4 ng/ml, p <0.001). The parallel increase was accounted for by patients with hypertriglyceridaemic lipoprotein phenotypes. In contrast, the level of activated factor VII (VIIa) neither differed significantly between patients and controls, nor between patients with different lipoprotein phenotypes. The elevated TFPI activity in the patients was closely associated with the plasma level of dense low density lipoprotein (LDL) particles (r = 0.46, p <0.001) and with the plasma concentration of the small, dense high density lipoprotein (HDL) subspecies HDL3b (r = 0.34, p <0.01).

 

  • References

  • 1 Broze Jr GJ. The role of tissue factor pathway inhibitor in a revised coagulation cascade. Semin Hematol 1992; 29: 159-69
    PubMedGoogle Scholar
  • 2 Broze Jr GJ, Warren LA, Novotny WF, Higuchi DA, Girard JJ, Miletich JP. The lipoprotein-associated coagulation inhibitor that inhibits the factor VH-tissue factor complex also inhibits factor Xa: Insight into its possible mechanism of action. Blood 1988; 71: 335-43
    PubMedGoogle Scholar
  • 3 Broze Jr GJ, Girard TJ, Novotny WF. Regulation of coagulation by a multivalent Kunitz-type inhibitor. Biochemistry 1990; 29: 7539-46
    CrossrefPubMedGoogle Scholar
  • 4 Davies MJ, Woolf N. Atherosclerosis: What is it and why does it occur?. Br Heart J 1993; 69 (Suppl): S3-S11
    CrossrefPubMedGoogle Scholar
  • 5 Wilcox JN, Smith KM, Schwartz SM, Gordon D. Localization of tissue factor in the normal vessel wall and in the atherosclerotic plaque. Proc Natl Acad Sci USA 1989; 86: 2839-43
    CrossrefPubMedGoogle Scholar
  • 6 Sandset PM, Simes PA, Abildgaard U. Factor VII and extrinsic pathway inhibitor in acute coronary disease. Br J Haematol 1989; 72: 391-6
    CrossrefPubMedGoogle Scholar
  • 7 Sandset PM, Abildgaard U, Larsen ML. Heparin induces release of extrinsic coagulation pathway inhibitor (EPI). Thromb Res 1988; 50: 803-13
    CrossrefPubMedGoogle Scholar
  • 8 Novotny WF, Girard TJ, Miletich JP, Broze Jr GJ. Purification and characterization of the lipoprotein-associated coagulation inhibitor from human plasma. J Biol Chem 1989; 264: 18832-7
    PubMedGoogle Scholar
  • 9 Lesnick P, Vonica A, Guérin M, Moreau M, Chapman MJ. Anticoagulant activity of tissue factor pathway inhibitor in human plasma is preferentially associated with dense subspecies of LDL and HDL and with Lp(a). Arterioscler Thromb 1993; 13: 1066-75
    CrossrefPubMedGoogle Scholar
  • 10 Sandset PM, Lund H, Norseth J, Abildgaard U, Ose L. Treatment with hydroxymethylglutaryl-coenzyme A reductase inhibitors in hypercholesterolemia induces changes in the components of the extrinsic coagulation system. Arterioscler Thromb 1991; 11: 138-45
    CrossrefPubMedGoogle Scholar
  • 11 Silveira A, Karpe F, Blombäck M, Steiner G, Walldius G, Hamsten A. Activation of coagulation factor VII during alimentary lipemia. Arterioscler Thromb 1994; 14: 60-9
    CrossrefPubMedGoogle Scholar
  • 12 Scarabin PY, Bara L, Samama M, Orssaud G. Further evidence that activated factor VII is related to plasma lipids. Br J Haematol 1985; 61: 186-7
    CrossrefPubMedGoogle Scholar
  • 13 Hamsten A. Studies on myocardial infarction at young age. Metabolic, haemostatic and familial factors in post-infarction patients below the age of 45.. M. D. Thesis. Karolinska Institute; 1986
    Google Scholar
  • 14 Karpe F, Bard J-M, Steiner G, Carlsson LA, Fruchart J-C, Hamsten A. HDLs and alimentary lipemia. Studies in men with previous myocardial infarction at a young age. Arterioscler Thromb 1993; 13: 11-22
    CrossrefPubMedGoogle Scholar
  • 15 Karpe F, Steiner G, Olivecrona T, Carlsson LA, Hamsten A. Metabolism of triglyceride-rich lipoproteins during alimentary lipemia. J Clin Invest 1993; 91: 748-58
    CrossrefPubMedGoogle Scholar
  • 16 Hamsten A, Blombäck M, Wiman B, Svensson J, Szamosi A, de Faire U, Mettinger L. Haemostatic function in myocardial infarction. Br Heart J 1986; 55: 58-66
    CrossrefPubMedGoogle Scholar
  • 17 Sandset PM, Larsen ML, Abildgaard U, Lindahl AK, Ødegaard OR. Chromogenic substrate assay of extrinsic pathway inhibitor (EPI): levels in the normal population and relation to cholesterol. Blood Coag Fibrinol 1991; 2: 425-33
    CrossrefPubMedGoogle Scholar
  • 18 Owren PA, Aas K. The control of dicumarol therapy and the quantitative determination of prothrombin and proconvertin. Scand J Clin Lab Invest 1951; 3: 201-18
    CrossrefPubMedGoogle Scholar
  • 19 Carlson K. Lipoprotein fractionation. J Clin Pathol 1973; 5 Suppl (Suppl. 26) 32-7
    PubMedGoogle Scholar
  • 20 Tornvall P, Karpe F, Carlson LA, Hamsten A. Relationships of low density lipoprotein subfractions to angiographically defined coronary artery disease in young survivors of myocardial infarction. Atherosclerosis 1991; 90: 67-80
    CrossrefPubMedGoogle Scholar
  • 21 Chapman MJ, Laplaud PM, Luc G, Forgez P, Biuckert E, Guulinet S, Lagrange D. Further resolution of the low density lipoprotein spectrum in normal human plasma: physicochemical characteristics of discrete subspecies separated by density gradient ultracentrifugation. J Lipid Res 1988; 29: 442-58
    PubMedGoogle Scholar
  • 22 Johansson J, Carlson LA, Landou C, Hamsten A. High density lipoproteins and coronary atherosclerosis. A strong inverse relation with the largest particles is confined to normotriglyceridemic subjects. Arterioscler Thromb 1991; 11: 174-82
    CrossrefPubMedGoogle Scholar
  • 23 Blanche PJ, Gong EL, Forte TM, Nichols AV. Characterization of human high density lipoproteins by gradient gel electrophoresis. Biochim Biophys Acta 1981; 665: 408-19
    CrossrefPubMedGoogle Scholar
  • 24 Zlatkis A, Zak B, Boyle A. A new method for direct determination of serum cholesterol. J Lab Clin Med 1953; 41: 486-92
    PubMedGoogle Scholar
  • 25 Fletcher MJ. A colorimetric method for estimating serum triglycerides. Clin Chim Acta 1968; 22: 393-7
    CrossrefPubMedGoogle Scholar
  • 26 Carlson LA. Determination of serum triglycerides. J Atheroscler Res 1963; 3: 334-6
    CrossrefPubMedGoogle Scholar
  • 27 Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with the Folin fenol reagent. J Biol Chem 1951; 193: 265-75
    PubMedGoogle Scholar
  • 28 Poapst M, Uffelman K, Steiner G. The chromogenicity and quantitation of apo B-100 and apo B-48 of human plasma lipoproteins on analytical SDS gel electrophoresis. Atherosclerosis 1987; 65: 75-88
    CrossrefPubMedGoogle Scholar
  • 29 Novotny WF, Brown SG, Miletich JP, Rader DJ, Broze Jr GJ. Plasma antigen levels of lipoprotein-associated coagulation inhibitor in patient samples. Blood 1991; 78: 387-93
    PubMedGoogle Scholar
  • 30 Warr TA, Warn-Cramer BJ, Rao LVM, Rapaport SI. Human plasma extrinsic pathway inhibitor activity: I. Standardization of assay and evaluation of physiologic variables. Blood 1989; 74: 201-6
    PubMedGoogle Scholar
  • 31 Sandset PM, Hpgevold HE, Lyberg T, Andersson TR, Abildgaard U. Extrinsic pathway inhibitor in elective surgery: a comparison with other coagulation inhibitors. Thromb Haemost 1989; 62: 856-60
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Bajaj MS, Rana SV, Wysolmerski RB, Bajaj SP. Inhibitor of the factor Vlla-tissue factor complex is reduced in patients with disseminated intravascular coagulation but not in patients with severe hepatocellular disease. J Clin Invest 1987; 79: 1874-8
    CrossrefPubMedGoogle Scholar
  • 33 Lindahl AK, Sandset PM, Abildgaard U, Andersson TR, Harbitz TB. High plasma levels of extrinsic pathway inhibitor and low levels of other coagulation inhibitors in advanced cancer. Acta Chir Scand 1989; 155: 389-93
    PubMedGoogle Scholar
  • 34 Lesnik P, Rouis M, Skarlatos S, Kruth HS, Chapman MJ. Uptake of exogenous free cholesterol induces upregulation of tissue factor expression in human monocyte-derived macrophages. Proc Natl Acad Sci USA 1992; 89: 10370-4
    CrossrefPubMedGoogle Scholar
  • 35 Witztum JL, Steinberg D. Role of oxidized LDL in atherogenesis. J Clin Invest 1991; 88: 1785-92
    CrossrefPubMedGoogle Scholar
  • 36 Tribble DL, IIoll LG, Wood TD, Krauss RM. Variations in the oxidative susceptibility among six low density lipoprotein subfractions of differing density and particle size. Atherosclerosis 1992; 93: 189-99
    CrossrefPubMedGoogle Scholar
  • 37 De Graaf J, Hak-Lemmers HLM, Hectors MPC, Demacker PNM, Hendricks JCM, Stalenhoef AFH. Enhanced susceptibility to in vitro oxidation of the dense low density lipoprotein subfraction in healthy subjects. Arterioscler Thromb 1991; 11: 298-306
    CrossrefPubMedGoogle Scholar
  • 38 Dejagei S, Biuckeit E, Chapman MJ. Dense low-density lipoprotein subspecies with diminished oxidative resistance predominate in combined hyperlipidemia. J Lipid Res 1993; 34: 295-308
    PubMedGoogle Scholar
  • 39 Lindahl AK, Abildgaard U, Larsen ML, Staalesen R, Hammer AKG, Sandset PM, Nordfang O, Beck TC. Extrinsic pathway inhibitor (EPI) released to the blood by heparin is a more powerful coagulation inhibitor than is recombinant EPI. Thromb Res 1991; 62: 607-14
    CrossrefPubMedGoogle Scholar
  • 40 Lindahl AK, Jacobsen PB, Sandset PM, Abildgaard U. Tissue factor pathway inhibitor with high anticoagulant activity is increased in postheparin plasma and in plasma from cancer patients. Blood Coag Fibrinol 1991; 2: 713-21
    CrossrefPubMedGoogle Scholar