Mechanisms of coexistence of factor VII hyperactivity with dyslipidaemia, diabetes mellitus, obesity and its role in the development of myocardial infarction: A review

Abstract

Myocardial infarction (MI) is one of the terminal complications of the cardiovascular disease, with high global mortality rate, accounting for 7.3 million deaths worldwide. It has a wide range of risk factors, including metabolic disorders and, presumably, factor VII (FVII) hyperactivity. However, the causal link of FVII hyperactivity with MI in the presence of metabolic disorders is still an area of uncertainty. The review investigated the mechanisms of coexistence of FVII hyperactivity with dyslipidaemia, diabetes mellitus, obesity and its role in the development of MI. Original articles were targeted. Various words combination was used to search for articles of relevance. Science Direct, Google Scholar, PubMed, NIH Public Access, Medline, PMC and Medscape were sites (techniques) used to search for the articles and related papers. A total of 140 papers and articles were retrieved and 102 of them were found suitable for literature review for the topic in question. Literature reported controversial results regarding association of FVII hyperactivity with MI. Some researchers found FVII hyperactivity to be an independent risk factor and predictor of myocardial infarction (MI), while some did not agree. Methods of different sensitivities; associated risk factors of MI; the stage of MI at which FVII activity was estimated; the presence of FVII mutated gene (353 Arg-Gln) and different interpretations of results were the sources of the discrepancy. Factor VII hyperactivity does not develop without other atherogenic risk factors. Dyslipidaemia, DM and obesity were found to induce FVII hyperactivity. Hyperglycaemia, insulin resistance, high levels of FFAs and leptin constitute the underlying mechanisms for coexistence of FVII hyperactivity and metabolic disorders. Factor VII hyperactivity does not cause development of MI de novo. In conclusion, factor VII hyperactivity plays a secondary role in the development of MI. It is induced by other risk factors associated with it. Metabolic disorders are the most confounding risk factors that FVII hyperactivity is often associated with in MI. Improvement of metabolic parameters decreases the levels of FVII activity, the risk for development of MI and controls its severity.

Keywords: Factor VII, myocardial infarction, obesity, diabetes mellitus, dyslipidaemia.