Low protein Z plasma levels are independently associated with acute coronary syndromes

Sandra Fedi, Francesco Sofi, Daria Brogi, Irene Tellini, Francesca Cesari, Ilaria Sestini, Alessandra Gazzini, Marco Comeglio, Rosanna Abbate, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review


Protein Z (PZ) is a single chain vitamin-K-dependent glycoprotein synthesized by the liver. Studies in vivo and in vitro suggest that PZ plays an important role in inhibiting coagulation as it serves as cofactor for the inactivation of factor Xa by forming a complex with the plasma PZ-dependent protease inhibitor. Recently, conflicting findings on plasma PZ levels in patients with ischemic stroke have been published. Aim of our study was to investigate the role of PZ in acute coronary syndromes (ACS). PZ plasma levels were determined in 223 (189 M; 34 F) patients with ACS referring to the Coronary Intensive Therapy Unit of University of Florence and in 265 (219 M; 46 F) healthy subjects. Patients under oral anticoagulation treatment as well as subjects with positivity for antiphospholipid antibodies were excluded. None had liver or kidney dysfunction. The mean PZ plasma level was lower in patients (1508 ± 730 ng/mL) than in controls (1728 ± 594 ng/mL) (p <0.0001). PZ levels below the 5th percentile (565 ng/mL) of normal values distribution in control subjects were found in 15.7% of patients and in 4.9% of controls (p

Original languageEnglish
Pages (from-to)1173-1178
Number of pages6
JournalThrombosis and Haemostasis
Issue number6
Publication statusPublished - Dec 2003


  • Acute myocardial infarction
  • Factor Xa
  • Protein Z (PZ)
  • Protein Z-dependent protease inhibitor
  • Unstable angina

ASJC Scopus subject areas

  • Hematology


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