title: Correlation between baseline plasminogen activator inhibitor levels and clinical outcome during therapy with tissue plasminogen activator for acute myocardial infarction.
abstract: Baseline plasminogen activator inhibitor (PAI) levels were examined for their influence on the responses to thrombolysis with recombinant tissue plasminogen activator (rt-PA) administered for acute myocardial infarction during the Thrombolysis and Myocardial Infarction (TAMI)-I study. Baseline PAI activity was 19 +/- 21 IU/ml (normal less than 5 IU/ml) and baseline PAI-1 antigen 54 +/- 53 ng/ml (normal 27 +/- 16 ng/ml), confirming previous findings of elevated PAI levels during acute myocardial infarction. Among clinical outcomes, lower PAI-1 antigen levels correlated weakly with greater patency at the 90 min angiogram. Thus, high baseline plasma PAI-1 levels may be detrimental to reperfusion with t-PA. There was no correlation with other major in-hospital clinical outcomes including reocclusion at the 7-10 day angiogram, survival to discharge, or bleeding. During the follow up period of 2.0 +/- 0.4 years, no relationship between baseline PAI levels and post-discharge reinfarction was observed.
authors.affiliation: Department of Medicine, Duke University, Durham, NC.
authors.forename: D C
authors.initials: DC
authors.lastname: Sane
authors.forename: D C
authors.initials: DC
authors.lastname: Stump
authors.forename: E J
authors.initials: EJ
authors.lastname: Topol
authors.forename: K N
authors.initials: KN
authors.lastname: Sigmon
authors.forename: D J
authors.initials: DJ
authors.lastname: Kereiakes
authors.forename: B S
authors.initials: BS
authors.lastname: George
authors.forename: S J
authors.initials: SJ
authors.lastname: Mantell
authors.forename: E
authors.initials: E
authors.lastname: Macy
authors.forename: D
authors.initials: D
authors.lastname: Collen
authors.forename: R M
authors.initials: RM
authors.lastname: Califf
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001780:Blood Coagulation Tests; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D015849:Plasminogen Inactivators / Q000097:blood*; D011379:Prognosis; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D015849:Plasminogen Inactivators; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator