Predictive Haemostatic Variables In Cardiovascular Disease

6 August 2005
11:00 to 14:30
Pyrmont Room
Sydney Convention and Exhibition Centre

Chairman: P.J. Grant, UK
Co-Chairs: G. Lowe, UK; G. Palareti, Italy; V. Salomaa, Finland; A. Tosetto, Italy

Audience: between 80-100 participants

Update on meta-analyses of fibrinogen, CRP, IL-6, vWF,tPA and D-dimer in prediction of vascular risk. Professor G.D.O Lowe, Glasgow , UK .

This talk reviewed a metanalysis of 31 studies of fibrinogen and vascular risk involving ~ 154,000 individuals. The methods involved have been previously published (Eur J Card Prev Rehab, 2004). A 3 fold increase in CV risk was seen in the top 20% of fibrinogen levels. Similar relationships existed between fibrinogen levels and both stroke and non=vascular deaths. Neither the fibrinogen assay used by the investigators, nor time to assay affected the results.

CRP had a weaker association with vascular risk than fibrinogen and seemed to show more variation with storage than fibrinogen. Other variables had weaker associations with CV risk

Proteomics and Haemostasis: An update on the plasma clot proteome. Dr A. M. Carter . Leeds UK .

The relative information gained by examining the genome, transcriptome and proteome was discussed. The plasma proteome is difficult to characterise, there is a wide dynamic range of proteins with albumin alone accounting for 55% of proteins in plasma. The Human Proteome Organisation was discussed and the aims and objectives of the plama proteome project outlined. Standardisation of methodologies is a problem and reference samples are being developed and sent out to participating laboratories.

Increased numbers of circulating endothelial cells predict poor outcome in acute coronary syndromes. A. Blann, Birmingham , UK

The potential for measurement of circulating endothelial cells (CECs) as a marker of vascular disease was discussed. CECs are recognised by the presence of CD146 and generally exist in concentrations of ~ 1 cell/ml of venous blood. In acute coronary syndromes this may rise to ~20 cells/ml of venous blood. Increased CECs have also been described in a variety of inflammatory states.

Methodological issues were discussed, in particular the problem of differentiating CECs from circulating progenitor cells, a problem that doesn’t appear to have been entirely resolved.

The adipocyte and cardiovascular risk. J. Prins, Brisbane , Australia

Recent work on the paracrine and endocrine effects of the fat filled visceral adipocyte was presented. The cardiovascular system was described in novel terms of obeying the messages sent out by the adipocyte and the brain. The obese adipocyte secretes 3 times as much TNF alpha and also secretes increased renin angiotensin activity, PAI-1, leptin, with suppressed adiponectin. The structure function of adiponectin and its receptors was discussed.

Multiple Environmental and Genetic assessment of risk factors for venous thrombosis, the MEGA Study. C. Doggen. Netherlands

The MEGA study design was presented with preliminary data from this cohort. Interactions between FV Lei.den and contraceptive use was presented and the analysis of the data set was discussed.

P.J. Grant Sydney, August 2005