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KMID : 0880520070430010019
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Chonnam Medical Journal
2007 Volume.43 No. 1 p.19 ~ p.24
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An Elevated Level of Fibrinogen is a Risk Factor for Acute Myocardial Infarction due to Coronary Artery Spasm
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Cho Jung-Sun
Jeong Myung-Ho
Kim Weon
Choi Myung-Ja
Jeong Seon-Young
Hwang Seung-Hwang
Lee Seok
Chung Jong-Won
Yoon Nam-Sik
Hong Seo-Na
Lim Sang-yup
Lee Sang-Rok
Kim Kye-Hun
Sohn Il-Suk
Hong Young-Joon
Park Hyung-Wook
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
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Abstract
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Occlusive coronary artery spasm can induce acute myocardial infarction (AMI). The purpose of this study is to determine the risk factors for the development of AMI in patients with coronary vasospasm. Consecutive 231 patients with documented coronary vasospasm by ergonovine provocation test were devided into two patient groups: angina pectoris (group I: n=202, 49.5+/-11.5 years) and acute myocardial infarction (group II: n=29, 47.4+/-11.2 years). Baseline clinical characteristics were not different between both groups. Neither did the incidence of hypertension, diabetes mellitus and smoking history differ between both groups (diabetes 7.9 vs. 13.8%; hypertension 19.8 vs. 24.1%; smoking 48.0 vs. 48.3%, respectively). The levels of lipoprotein(a) [Lp(a)], fibrinogen, high sensitivity C-reactive protein (hsCRP), apolipoprotein B/A1 ratio were measured. The levels of hsCRP and fibrinogen were higher in group II (1.88+/-2.9 mg/dl, 317.5+/-51.2 mg/dl) than in group I (0.68+/-1.5 mg/dl, 263.2+/-70.3 mg/dl; p<0.001, p=0.002, respectively). The multivariate analysis revealed that the level of fibrinogen higher than 300 mg/dl is an independent determinant for the AMI due to occlusive vasospasm (OR=7.13, 95% CI=2.16 to 23.54, p=0.001). Elevated level of fibrinogen is associated with AMI due to occlusive coronary spasm, suggesting that fibrinogen may play an important role in the genesis of thrombotic coronary occlusion subsequent to coronary spasm.
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KEYWORD
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Vasospasm, Fibrinogen, Myocardial infarction
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