[Relationship between antithrombin-III value with acute coronary syndrome and preprocedural TIMI flow grade].

Objective To explore the differences of antiprothrombin-Ⅲ ( AT-Ⅲ ) value in patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP) and examine the association of AT-Ⅲ value with preprocedural thrombolysis in myocardial infarction (TIMI) flow in ACS patients.Methods This study prospectively included 121 hospitalized ACS patients between January 2011 to June 2011,including ST-segment elevation myocardial infarction (STEMI,n =50 ), non-ST segment elevation myocardial infarction (NSTEMI,n =32) and unstable angina (UAP,n =39).Meanwhile,50 SAP cases during the same period were selected as the control group.The AT-Ⅲ levels were measured by chromogenic substrate method before coronary angiography for all patients. Results (1) The AT-Ⅲ levels were significantly lower in the ACS patients than those in the SAP cases.(2) In the STEMI subgroup,the AT-Ⅲ levels were markedly lower in the patients with preprocedural TIMI flow grade ≤2 versus those with preprocedural TIMI flow grade 3 (86％ ± 11％ vs 93％ ±9％,P ＜0.05). (3) In the USTEMI/UAP subgroup,the mean levels of AT-Ⅲ were obviously lower in the patients with preprocedural TIMI flow grade ≤ 2 than those with preprocedural TIMI flow grade 3 ( 85％ ± 8％ vs 95％ ± 8％,P ＜ 0.01 ) and were notably lower in the patients with the culprit lesion stenosis ≥70％ versus those with stenosis ＜70％ ( 88％ ± 9％ vs 94％ ± 9％,P ＜ 0.01 ).(4) Multivariable analysis identified AT-Ⅲ value as an independent predictor of impaired preprocedural TIMI flow grade of culprit coronary artery in ACS patients.Conclusions The AT-Ⅲ levels were significantly lower in the ACS patients than those in the SAP patients.The activity of AT-Ⅲ is positively correlated with the TIMI flow grade in ACS patients.In contrast,the activity of AT-Ⅲ is negatively correlated with the severity of culprit vessel stenosis in the patients with NSTEMI.Thus AT-Ⅲ level may be used to distinguish high-risk populations in ACS patients at an early stage. Key words: Coronary artery disease; Antithrombin Ⅲ; Pulsatile flow