***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background —Numerous studies have suggested that microbial agents may promote atherosclerosis . A smaller body of research has suggested that acute respiratory infection may be a risk factor for myocardial infa rct ion ( MI ) . We hypothesized that influenza vaccine might reduce the risk of recurrent MI in patients with documented coronary heart disease ( CHD ) . Methods and Results —A case-control study was performed on 218 CHD patients seen at Memorial Hermann Hospital during the influenza season of October 1997 through March 1998 . Patients who experienced new MI were included in the case group , and those who did not experience new MI or unstable angina were assigned to the control group . Data were collected by structured review of patients ’ charts and through a subsequent telephone survey . Adjusted for history of influenza vaccination in previous years , multivariate logistic regression revealed risk of MI to be associated with current hypertension ( OR 4.96 , 95 % CI 2.06 to 11.96 , P < 0.0001 ) , hypercholesterolemia ( OR 4.08 , 95 % CI 1.67 to 9.99 , P = 0.002 ) , smoking ( OR 3.75 , 95 % CI 1.76 to 7.98 , P = 0.001 ) , and  influenza vaccination  ( OR 0.33 , 95 % CI 0.13 to 0.82 , P = 0.017 ) . Despite significant association in univariate analysis , multivitamin therapy and physical exercise were not associated with risk of reinfa rct ion in multivariate analysis . Conclusions —In this study in patients with chronic CHD , vaccination against influenza was negatively associated with the development of new MI during the same influenza season . However , to address causal inference , examination of prospect i ve data sets will be needed We have previously determined that there is a significant benefit of vaccination against influenza in patients hospitalized due to an acute coronary event . The purpose of this study is to determine whether the observed benefits of vaccination were maintained over a 2-year follow-up among those who were re-vaccinated during the subsequent winter season . During the winter season of 2001 , a total of 301 acute coronary patients were prospect ively enrolled within 72 hours of the onset of symptoms . Follow-up was conducted at 6 and 12 months . Patients who survived participated in a registry 1 year after the 2nd influenza vaccination period ( winter 2002 ) , as a cohort of chronic and stable coronary patients . The incidence of the primary endpoint cardiovascular death at 1 year was significantly lower in patients receiving vaccination than in controls ( 6 % vs 17 % , respectively ) by intention-to-treat analysis . The relative risk with vaccination  in comparison with controls was 0.34 ; 95 % confidence interval , 0.17 - 0.71 ; P = 0.002 . In the winter of 2002 , 116 patients were vaccinated according to their physicians ' instructions , and 114 subjects remained unvaccinated . The combined endpoints of total death plus myocardial infa rct ion 1 year later were 4 ( 3.4 % ) in the vaccinated group vs 11 ( 9.7 % ) among those who were not vaccinated ( P = 0.05 ) . Influenza vaccination may reduce the risk of death and ischemic events in patients admitted with acute coronary syndromes . There is also a beneficial trend in the quiescent phase of ischemia OBJECTIVES Our objective was to assess endogenous thrombolytic activity in acute coronary syndrome ( ACS ) patients and relate this to their likelihood of future adverse cardiovascular events . BACKGROUND Spontaneous lysis of platelet-rich thrombi is an important defense mechanism against lasting occlusion . Despite convincing evidence for the role of endogenous fibrinolysis in ACS , the prognostic value of plasma fibrinolytic markers in assessing risk is limited . We employed a novel global test which , in addition to platelet reactivity , allows assessment of endogenous thrombolytic activity to identify ACS patients who remain at risk of cardiovascular events . METHODS We used the global thrombosis test ( GTT ) to assess thrombotic and thrombolytic status in 300 ACS patients receiving dual-antiplatelet therapy .  The test assesses the time required to form an occlusive thrombus , the occlusion time ( OT ) , and the time to lyse this , the lysis time ( LT ) . The end point of the study at 12 months ' follow-up was the composite of death , nonfatal myocardial infa rct ion , or stroke . RESULTS The OT and LT were both prolonged in ACS patients compared with normal volunteers ( p < 0.001 ) . LT > or = 3,000 s occurred in 23 % of ACS patients versus none of the normal subjects and was a significant and independent predictor of cardiovascular death and nonfatal myocardial infa rct ion in a multivariate model adjusted for cardiovascular risk factors . LT > or = 3,000 s was the optimal cutoff value for predicting 12-month major adverse cardiovascular events ( hazard ratio [ HR ] : 2.52 , 95 % confidence interval : 1.34 to 4.71 , p = 0.004 ) and cardiovascular death ( HR : 4.2 , 95 % confidence interval : 1.13 to 15.62 , p = 0.033 ) . HR increased further as LT increased . No association was found between OT and the risk of major adverse cardiovascular events . CONCLUSIONS Assessment of endogenous thrombolytic status based on the lysis of platelet-rich thrombi from native blood using the point-of-care GTT can identify ACS patients at risk of future cardiac events 
    Output:
    
IgG antibodies that recognize epitope Gly40-Arg43 in domain I of b2–glycoprotein I cause LAC , and their presence correlates strongly with thrombosis .
3 Galli M , Luciani D , Bertolini G , Barbui T. Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome : a systematic review of the literature .
9 Moore GW , Smith MP , Savidge GF .
12 Burns ER , Goldberg SN , Wenz B. Paradoxic effect of multiple mild coagulation factor deficiencies on the prothrombin time and activated partial thromboplastin time .