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The purpose of this study was to assess the relative importance of thrombin generation and platelet activation in venous and arterial disorders. To this end Fibrinopeptide A (FPA) was used as an index of thrombin generation and Beta- thromboglobulin (BTG) as an index of platelet activation.FPA and BTG were determined by specific radioimmunoassays.  In 80 controls (age 19-70, mean 41 yrs) mean FPA concentration was 0.72 ± 0.47 (ng/ml ± SD) and mean BTG concentration 28.2 ± 10.1 (ng/ml ± SD).  In 51 patients with the symptoms of deep vein thrombosis (DVT) or pulmonary embolism (PE), in which these disorders were confirmed by phlebography and/or Doppler ultrasound or perfusion lungscanning, mean FPA and BTG concentrations were clearly elevated compared to mean FPA and BTG concentrations in controls and in 25 patients with the symptoms of DVT or PE in which these disorders could be excluded by the above named techniques. Heparin and phenprocoumon lowered FPA concentrations into the normal range, while the BTG concentrations remained elevated.  In 20 patients with intermittent claudication, in which peripheral vascular disease (PVD) was confirmed by Doppler ultrasound mean FPA concentration did not differ from that in controls, while the mean BTG concentration was obviously elevated. This picture did not change after 2 months of phenprocoumon therapy.  In 33 patients with angina pectoris in which coronary artery disease (CAD) was demonstrated by arteriography mean FPA concentration did not differ from that in 7 patients with angina pectoris in which no coronary lesions were present and in controls contrary to the mean BTG concentration, which was clearly elevated. Results in patients on phenprocoumon or acenocoumarol therapy were not different from those without oral anticoagulant treatment.  So far the experimental results indicate that in venous disorders (DVT or PE) fibrin formation plays a more important role than in arterial disorders (PVD or CAD).

Fibrinopeptide A And Beta-Thromboglobulin Concentrations In Venous And Arterial Disorders