Shortened activated partial thromboplastin time, a hemostatic marker for hypercoagulable state during acute coronary event

• Published in: Translational research : the journal of laboratory and clinical medicine 2010-06, Vol.155 (6), p.315-319
• Main Authors: Abdullah, Wan Zaidah, Moufak, Shaimaa K, Yusof, Zurkurnai, Mohamad, Mohd Sapawi, Kamarul, I.M
• Format: Article
• Language: English
• Subjects: Acute Disease; Biological and medical sciences; Biomarkers - analysis; Coronary Disease - complications; Cross-Sectional Studies; Factor VIII - analysis; General aspects; Hematologic and hematopoietic diseases; Hemostasis; Humans; Internal Medicine; Investigative techniques, diagnostic techniques (general aspects); Malaysia; Medical sciences; Outpatients; Partial Thromboplastin Time - statistics & numerical data; Platelet diseases and coagulopathies; Prospective Studies; Protein C - metabolism; Prothrombin Time; Thrombophilia - diagnosis; Time Factors
• ISSN: 1931-5244; 1878-1810
• DOI: 10.1016/j.trsl.2010.02.001

Various factors may contribute to a hypercoagulable state and acute vascular thrombosis. A prospective study was conducted involving 165 coronary heart disease (CHD) patients from the Cardiology Unit, Hospital Universiti Sains Malaysia. The purpose of this study was to investigate the relationship among factor VIII (FVIII), prothrombin time (PT), activated partial thromboplastin time (APTT), and activated protein C resistance (APC-R) state among CHD patients and to look for potential clinical applications from these laboratory findings. There were 110 cases diagnosed as acute coronary syndrome (ACS), whereas another 55 were stable coronary artery disease (SCAD) patients. PT, APTT, FVIII, and APC-R assays were performed on all subjects. There was a significant difference between the FVIII level and the APTT results ( P value < 0.0001). A negative relationship was found between the FVIII level and the APTT from linear regression analysis ( R2 = 10%, P value < 0.0001). For each 1% increase in the FVIII level, the APTT was reduced by 0.013 s (95% confidence interval (CI) between –0.019 and –0.007). Interestingly, none of the SCAD patients had abnormally short APTT. Approximately 68.4% of cases with a positive APC-R assay were found to have a high FVIII level. In conclusion, the APTT test is a potential hemostatic marker for hypercoagulable state including in arterial thrombosis.