TFPI antigen and activity levels in patients with asymptomatic atherosclerosis and target organ acute and chronic complications

AIM: In patients with atherosclerosis there is an activation of the tissue factor mediated coagulation cascade. The aim of our study was to ascertain if there is a relationship between increased tissue factor pathway inhibitor (TFPI) antigen and activity plasma levels and atherosclerosis. METHODS: Design: case-control study. Setting: Department of Internal Medicine and Cardiovascular Diseases, University of Palermo and Laboratory of Genetics and Molecular Biology, Mayo Clinic, Rochester, MN, USA. Patients: 63 consecutive patients with asymptomatic atherosclerosis or with its acute or chronic complications, and 20 healthy volunteers. Measurements: TFPI antigen was detected by an immunoenzimatic assay (Imunobind total TFPI ELISA kit, American Diagnostica Inc., USA). TFPI activity was evaluated by an activity assay (Actichrome TFPI activity assay, American Diagnostica Inc., USA). RESULTS: Patients with chronic (P=0.0001 for TFPI Ag, P=0.006 for TFPI Ac) and acute (P=0.04 for TFPI Ag, P=0.01 for TFPI Ac) vascular disease and with asymptomatic carotid plaque (P=0.0019 for TFPI Ag, P<0.05 for TFPI Ac) had significantly increased TFPI antigen and activity plasma levels vs healthy volunteers. Moreover, patients with chronic vascular disease had higher TFPI Ag levels vs patients with asymptomatic atherosclerosis (P=0.0013). CONCLUSIONS: The originality of our study was the finding of increased TFPI levels, not only in patients with acute complication of atherosclerosis, but also in those with chronic vascular disease and with asymptomatic carotid plaque.