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Angiogenesis, thrombogenesis, endothelial dysfunction and angiographic severity of coronary artery disease
  1. N A Chung,
  2. C Lydakis,
  3. F Belgore,
  4. F L Li-Saw-Hee,
  5. A D Blann,
  6. G Y H Lip
  1. Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK
  1. Correspondence to:
    Professor G Y H Lip
    Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK;


Background: Thrombogenesis, angiogenesis, and endothelial damage/dysfunction are components in the pathogenesis of atherosclerosis.

Objective: To investigate the relation of these variables to atherosclerotic disease severity and the possible interrelations between the three.

Methods: 111 patients attending for coronary angiography were studied (85 male, 26 female; mean (SD) age, 61.6 (10.0) years). Plasma concentrations of von Willebrand factor (vWf, a marker of endothelial damage/dysfunction), vascular endothelial growth factor (VEGF, associated with angiogenesis), soluble VEGF receptor Flt-1 (sFlt-1), and tissue factor (TF, a key component of coagulation) were measured by an enzyme linked immunosorbent assay. Following angiography, disease severity was assessed by the number of coronary vessels diseased (> 50% stenosis) and by a coronary atheroma score.

Results: All indices were raised in the patients compared with 34 healthy controls except sFlt-1, which was lower in the patients. No significant correlations were found between the coronary atheroma score and values of vWf (Spearman correlations: r  =  0.21, p  =  0.83), VEGF (r  =  0.11, p = 0.27), or TF (r  =  −0.04, p  =  0.68). However, there was an inverse correlation between plasma sFlt-1 and coronary atheroma score (r  =  −0.19, p  =  0.049). The number of vessels diseased had no relation to any marker. Correlations were found between TF and VEGF (r  =  0.25, p  =  0.008) and between TF and sFlt-1 (r  =  0.42, p < 0.001) in the patients.

Conclusions: Despite evidence of abnormal angiogenesis (VEGF and sFlt-1), thrombogenesis (TF), and endothelial damage/dysfunction (vWf) in the patients with coronary artery disease, there was no correlation between VEGF, sFlt-1, vWf, or TF and angiographically defined disease severity.

  • angiogenesis
  • thrombogenesis
  • endothelium
  • coronary artery disease
  • sFlt-1, soluble VEGF receptor Flt-1
  • TF, tissue factor
  • VEGF, vascular endothelial growth factor
  • VWf, von Willebrand factor

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