| BackgroundThrombosis has become the focus in studing the pathogenesis of coronaryheart disease and predicting its happening , development and prognosis. Hereditary andacquired factors can increase the risk of thrombosis. Recently, previous studies haveshown that prothrombin G20210A mutation and activated protein C resistance (APCR)are the most common hereditary condition of thrombosis in western countries.Prothrombin G20210A mutation can lead to plasma prothrombin level increase.Highlevel of plasma prothrombin is an independent risk factor for thrombosis.Antithrombin (AT) can inhibit the activity of thrombin.Deficiency or lower level of ATdecrease the capability of inactivating thrombin,which lead to hypercoagulability.APCR is characterized by insufficient anticoagulant response to activated protein C(APC). To our knowledge ,no reports are available in China about the association ofthe prothrombin G20210A mutation , APCR, AT Activity in coronary heart disease.Itwas still controversial in western countries.This study determined the prevalence ofthe prothrombin G20210A mutation , APCR and AT Activity in patients withcoronary heart disease and healthy control subjects in Henan area Han population,inorder to have a better insight into the pathogenesis of coronary heart disease from the molecular level and choose the effective molecular markers for predicting the happening , development and prognosis of coronary heart disease.Subjects&MethodsThe study group was composed of 127 patients with coronary heart disease,included 34 patients with acute myocardial infarction (AMI) (12 females , 22 males , mean age 55.8 years) , 30 patients with old myocardial infarction (OMI) ( 10females, 20 males, mean age 59.8 years) , 33 patients with unstable angina (UA) (13 females , 20 males , mean age 57 years) , 30 patients with stable angina (SA) (10 females , 20 males , mean age 54.6 years) and 54 normal healthy control subjects(NC) (24 females , 30 males , mean age 55 years) matched for age and sex in order to detect the prothrombin G20210A mutation , APCR , AT Activity. Another 72 normal healthy control subjects only were detected the prothrombin G20210A mutation.All subjects were Han nationality.Their function of liver and kidney were normal.During the week before the collection of blood samples,all subjects did not take up any medicine which influence the mechanisms of coagulation. The prothrombin G20210A mutation was detected by a polymerase-chain-reaction-based technique,digestion of products with Hind III restrictase and electrophoresis. APCR was measured as the ratio of Activated Partial Thromboplastin Times(APTT) with and without APC (APC Sensitivity Ratio, APC-SR, APC-SR=APTT+APC/APTT-APC) and normalized APC-SR (n-APC-SR, n-APC-SR =APC-SR of patients/APC-SR of pooled normal plasma). Antithrombin (AT) Activity was determined by the method of chromogenic substrate.Results1 . Detection of Prothrombin G20210A mutation:The G20210A mutation in the prothrombin gene was not found in 127 patients with coronary heart disease and in 126 healthy control subjects.2. Detection of APCR:n-APC-SR of NC was 1 .09 0. 10 ( x s , after one outliner removal ) , positive for APCR was defined by a n-APC-SR<0.79 ( 3s below the mean n-APC-SR of NC ) . The incidence of APCR in UA ?AMI , OMI were 18. 18%, 17. 64%, 16. 67% respectively,significantly higher than that of NC group ( 1.85%) (p <0.05),but there was no significant difference between SA group(6.67%) and NC group(p>0.05). The mean value of n-APC-SR was significantly lower in coronary heart disease patients than in control healthy subjects (p<0.05) . The mean value of n-APC-SR was significantly lower in UA and AMI groups than in OMI group (0.010.05) ,between OMI and S A groups (p>0.05) .3. Detection of AT Activity:The AT Activity is significantly lower in patients than in control healthy subjects(p<...
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