Plasma tissue plasminogen activator and plasminogen activator inhibitor-1 levels in acute myocardial infarction

Apar Kishor Ganti, Anil Potti, Radha Yegnanarayan

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Abstract

The cause of the circadian variation in the incidence of acute myocardial infarction (AMI) has not been identified. Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) have opposing effects on thrombi. Hence, the extent of the clot, the size of the infarct and outcome of patients could depend on t-PA and PAI-1 levels. In an effort to elucidate the pathophysiologic basis of circadian variation of AMI, we investigated the presence of a possible corresponding circadian variation in the levels of endogenous t-PA and PAI-1 in patients diagnosed to have AMI and the effects of hypertension, diabetes and site of the infarct on these levels. We estimated the levels of t-PA and PAI-1 in platelet-poor plasma of 42 patients with AMI on admission, using the enzyme-linked immunosorbant assay. Although not statistically significant, patients having an AMI in the morning hours had the highest t-PA:PAI-1 ratio. The normal circadian variation in PAI-1 levels was lost in patients with AMI, probably due to the disease process. Also, the t-PA levels in hypertensive patients were significantly lower than in nonhypertensives. PAI-1 levels were also significantly lower in patients with ante-roseptal than in inferior and anterolateral AMI. This relationship between the fibrinolytic potential and the site of infarction needs further study. Furthermore, t-PA levels on admission were significantly lower in survivors and may have a predictive value in determining the outcome.

Original languageEnglish (US)
Pages (from-to)80-84
Number of pages5
JournalPathophysiology of Haemostasis and Thrombosis
Volume32
Issue number2
DOIs
StatePublished - Dec 1 2002

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Keywords

  • Circadian rhythm
  • Myocardial infarction, acute
  • Plasminogen activator inhibitor-1
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Hematology
  • Physiology (medical)

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