Abstract
In order to elucidate the relationship between hyperglycemia and both the concentration and solubility of circulating plasma soluble fibrin monomer complexes (SFMC), in the course of acute myocardial infarction (AMI), 15 cases of AMI with various degrees of glucose intolerance were studied. Furthermore, the effect of a high glucose concentration on the fibrin fiber diameter was observed experimentally.In the Group I patients (comprised of 8 impaired glucose tolerance (IGT) cases among 10 patients, Fructosamine (FRA)≤285μmol/l), the elevated SFMC and Fbg concentrations had decreased to nearly the same level as the pretreatment value by the 14 th hospital day. On the other hand, in the Group II patients (comprised of 5 diabetics, FRA>285μmol/l), the high SFMC level became more elevated and the increased Fbg concentration had not decreased by the 14 th hospital day.Plasma Fn levels of both groups did not show a significant increase over this period.The ratio of Fn to fibrin (ogen) obtained as a marker of SFMC solubility had increased markedly by the 14 th hospital day, and exhibited a mirror image when compared with the change in SFMC level.In contrast, Group II showed a tendency for this ratio to decrease.The fibrin fiber diameter formed from glycated Fbg and Fn was enlarged.
These results suggest that persistent hyperglycemia may induce prolonged intravascular thrombin generation and the formation of SFMC with low solubility.As this seems to be an unfavorable condition for patients with AMI, it is concluded that glycemic control is particularly important for diabetic patients with AMI.
