Low protein Z plasma level is a risk factor for acute myocardial infarction in coronary atherosclerosis disease patients

Thromb Res. 2016 Dec:148:25-31. doi: 10.1016/j.thromres.2016.10.010. Epub 2016 Oct 13.


Objectives: To examine plasma protein Z (PZ) levels in acute myocardial infarction (AMI) and chronic coronary atherosclerosis disease (CCAD) patients without history of AMI and explore its potential clinical significance.

Methods: Plasma PZ concentrations were measured in 90 AMI patients (Group A), 87 CCAD patients without AMI history who remained free of major clinical events at least one year (Group B), and 88 clinically healthy controls (Group C).

Results: PZ was found to be significantly lower (P<0.001) in Group A (1508.5±486.2ng/mL) compared with Group B (1823.0±607.8ng/mL) and C (2001.7±733.0ng/mL) and in Group A+B compared with Group C (Group A+B 1663.1±570.0 ng/mL, P<0.001). No statistically significant difference was reached between Group B and C (P=0.081). PZ level was significantly correlated with concentration of creatine kinase MB, high sensitive-cardiac troponin T, high sensitive C reactive protein, D-dimer and coagulation factor II and may be a useful predictor for AMI (OR: 1.38, 95% CI: 1.13-1.77, P=0.03). Subgroup analysis showed PZ concentration below the lowest tertile (<1398ng/mL) had a significantly increased risk for AMI and CCAD (OR: 3.39; 95% CI: 1.12-10.31; P=0.03 and OR: 7.39; 95% CI: 2.62-20.79; P<0.001 respectively).

Conclusions: PZ deficiency is found in AMI patients and could potentially reflect the myocardium injury, local coagulation activation and inflammation response during the acute phase of coronary atherosclerosis disease.

Keywords: Blood coagulation; Coronary atherosclerosis; Inflammation; Myocardial infarction; Plasma protein Z.

MeSH terms

  • Aged
  • Blood Coagulation
  • Blood Proteins / analysis*
  • C-Reactive Protein / analysis
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / complications*
  • Creatine Kinase, MB Form / blood
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / etiology*
  • Risk Factors


  • Blood Proteins
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • plasma protein Z
  • C-Reactive Protein
  • Creatine Kinase, MB Form