Remnant lipoproteins have been identified as atherogenic lipoproteins. Recently, remnant-like particles (RLP), which are almost identical to the remnant lipoproteins, were measured rapidly using anti-apo A-1 and anti-apo B-100 immunoafinity gel suspension. To evaluate the association of RLP with the coagulation/fibrinolytic system which plays an important role in the pathogenesis of myocardial infarction, we examined the correlations between plasma levels of RLP and coagulation/fibrinolytic markers in patients with myocardial infarction.
Methods: The subjects were 107 patients with myocardial infarction not receiving antihyperlipidemic or anticoagulant agents. Blood sampling was performed at least 6 months or longer after the onset of myocardial infarction. We measured fasting blood concentrations of total cholesterol, triglyceride, HDLcholesterol, RLP-cholesterol, RLP-triglyceride, fibrinogen, factor VII (FVII) antigen, activated factor VII (FVIIa), tissue factor, prothrombin fragment 1+2, and plasminogen activator inhibitor-I.
Results: In simple regression analysis, the plasma levels of RLP-triglyceride showed significant positive correlations with plasma levels of FVIIa and the FVIIa/FVII ratio (r=0.21, p<0.05 and r=0.20, p<0.05, respectively). In normolipidemic patients (n=72), RLP-triglyceride showed a positive correlation with FVIIa (r=0.31, p<0.01), FVIIa/FVII ratio (r=0.34, p<0.01), and plasminogen activator inhibitor-I (r=0.24, p<0.05). In hyperlipidemic patients (n=35), RLPtriglyceride showed a positive correlation with FVIIa (r=0.35, p<0.05), FVIIa/FVII ratio (r=0.37, p<0.05). None had significant correlations with plasma levels of the FVII antigen, tissue factor, or prothrombin fragment 1+2.
Conclusions: RLP-triglyceride may be involved in the pathogenesis of myocardial infarction by activating the extrinsic coagulation pathway and suppressing fibrinolytic activity.
