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Thromb Haemost 2004; 91(02): 388-393
DOI: 10.1160/TH03-07-0442
Cell Signalling and Vessel Remodelling
Schattauer GmbH

Long term prognosis of patients with myocardial infarction and normal coronary angiography: impact of inherited coagulation disorders

Antoine Da Costa
1   Division of Cardiology, University Jean Monnet of Saint-Etienne, Saint-Etienne, France
,
Brigitte Tardy
2   Division of Hematology, Saint-Etienne, France
,
Kamel Haouchette
1   Division of Cardiology, University Jean Monnet of Saint-Etienne, Saint-Etienne, France
,
Patrick Mismetti
3   Division of Clinical Pharmacology, Saint-Etienne, France
,
Alexis Cerisier
1   Division of Cardiology, University Jean Monnet of Saint-Etienne, Saint-Etienne, France
,
Michel Lamaud
1   Division of Cardiology, University Jean Monnet of Saint-Etienne, Saint-Etienne, France
,
Denis Guyotat
2   Division of Hematology, Saint-Etienne, France
,
Karl Isaaz
1   Division of Cardiology, University Jean Monnet of Saint-Etienne, Saint-Etienne, France
› Author Affiliations
Further Information

Publication History

Received 05 July 2003

Accepted after revision 24 October 2003

Publication Date:
01 December 2017 (online)

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Summary

The prognosis of patients with myocardial infarction (MI) and normal coronary arteries (NCA) in the presence of an inherited coagulation disorder is unknown. The purpose of this study was to compare the clinical thrombosis outcome of patients with (GpI) or without (GpII), inherited coagulation disorders, who suffered from an acute MI with NCA. Eighty two consecutive patients (mean age 49 ± 15 years; 29 females) with MI, but NCA, were recruited. Twelve patients (15%) had an inherited coagulation disorder. GpI and GpII were statistically similar regarding age (45 ± 11 vs 50 ± 16 years-old), gender (33 vs. 36% female), tobacco consumption (50 vs. 53%), diabetes mellitus (8 vs. 10%), hypertension (25 vs. 17%), obesity (8.3 vs. 14%), family history of coronary heart disease (33 vs. 19%), hypercholesterolemia (50 vs. 21%; p = . 08), left ventricular ejection fraction (58 ± 13 vs. 61 ± 13%) and spasm (8.3% vs. 17%). All patients were initially treated with antiplatelet agents with the exception of one (8%) in GpI, and 6 (9%) in GpII who were taking oral anticoagulant therapy (ns). The mean follow-up was 57 ± 26 (range from 2-91 months). During the outcome, 12/78 (15.4%) thrombosis events occurred, including venous thrombosis or pulmonary embolism (1/12 vs. 1/66), reinfarction (2/12 vs. 4/66), and stroke (2/12 vs. 2/66), with two events in one patient (GpI). Kaplan-Meier event-free survival, with combined end-point, defined as venous thrombo-embolic event, reinfarction, or stroke differed between the two groups: 4/12 (33.3%) in GpI and 7/66 (10.6%) in Gp II (p <. 02). Patients with MI, NCA and congenital coagulation disorder present a high risk of thrombosis recurrence under antiplatelet agent.

Presented in part at the 52nd Annual Scientific Session of the American College of Cardiology; March 30-April 2, Chicago USA 2003, Abstract.

Keywords

Myocardial infarction - prognosis - angiographically normal coronaries - inherited coagulation disorders
 

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