Endogenous heparin--a protective marker in patients with myocardial infarction.

BACKGROUND

In patients with myocardial infarction and initial high serum levels of immunoglobulin E (IgE), lower mortality and a smaller quantity of complications were observed. The aim of this study was to evaluate whether there was a relationship between IgE serum levels and plasma concentration of endogenous heparin in patients with myocardial infarction. Furthermore, we attempted to analyse whether there was relationship between endogenous heparin plasma concentrations and the specific markers (thrombin-anti-thrombin \TAT\complexes) for thrombinogenesis.

METHODS

Thirty-five healthy individuals and 64 patients with recent myocardial infarction (MI), aged 37-70 years were enrolled in the study. Patients with MI who had suffered cardiac arrest and cardiogenic shock before admission to hospital, or had inflammatory diseases or a negative allergic history were excluded. Serum IgE concentrations (UniCAP), TAT complexes in plasma (ELISA, Behring) and endogenous heparin plasma levels (Coatest Heparin) were measured at the time of admission and before treatment.

RESULTS

There were striking differences between the heparin concentrations in patients with MI and the control group ( p< 0.0001). Higher levels of IgE were strongly correlated with higher concentrations of endogenous heparin ( r= 0.80, p < 0.001). Strong statistically significant negative correlations between higher endogenous heparin concentrations and TAT complex levels were also found (r = -0.57, p < 0.001).

CONCLUSIONS

The results suggest that high concentrations of endogenous heparin in association with high IgE concentrations and their negative influence on thrombinogenesis, may act as a marker for a favourable prognosis in patients with MI.