Coagulation and Fibrinolysis

Processes involved in thrombus formation include not only those required for the formation of a stable thrombus (platelet aggregation and blood clotting) but also a mechanism to dissolve the thrombus (fibrinolysis). Long-term prospective epidemiologi-cal studies have reported that in healthy men factor VII coagulant activity (factor VIIc) and fibrinogen concentrations were higher in subjects who developed cardiovascular diseases at a later stage of the study. Factor VIIc in particular was associated with an increased risk of dying from cardiovascular disease. A high concentration of plasminogen activator inhibitor type 1 (PAI-1) indicates impaired fibrino-lytic capacity of the plasma and is associated with increased risk of occurrence of coronary events.

Saturated fatty acids can affect the plasma activity of some of these coagulation and fibrinolytic factors and thus the prethrombotic state of the blood. However, the effects of saturated fatty acids on coagulation and fibrinolytic factors in humans, unlike effects on cholesterol concentrations, have received little attention, and few well-controlled human studies have been reported. Also, regression equations derived from a meta-analysis, which predict the effects on coagulation and fibrinolytic factors of different fatty acid classes compared with those of carbohydrates, do not exist. Therefore, the reference fatty acid is dependent on the experiment discussed. In the epidemiological studies that have found associations between CHD risk and factors involved in thrombogenesis or atherogenesis, subjects were mostly fasted. Also, the effects of saturated fatty acids on cholesterol metabolism, platelet aggregation, and coagulation and fibrinolysis have been studied mainly in fasted subjects. It should be noted, however, that concentrations of some coagulation factors (e.g., factor VIIc) and fibrinolytic factors change after a meal.

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