Tissue-plasminogen activator, plasminogen activator inhibitor and risk of peripheral arterial disease.
In this population-based case-control study, we examined the relationship between the fibrinolytic variables tissue-plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI) activity, cardiovascular risk factors and peripheral arterial disease. Cases and controls were selected from the Edinburgh Artery Study, a random sample survey of men and women, aged 55-74 years. Mean levels of t-PA antigen and PAI activity were significantly elevated in 121 cases compared to 126 controls. The increased risks of peripheral arterial disease with increasing PAI activity and t-PA antigen levels were partly mediated by interactions with serum triglycerides, high density lipoprotein (HDL) cholesterol and cigarette smoking. For example, adjustment for triglycerides significantly reduced the odds of disease for PAI activity from 1.41 (95% confidence intervals 1.08, 1.86) to 1.24 (0.93, 1.65) and from 1.47 (1.09, 1.98) to 1.34 (0.99, 1.82) for t-PA antigen. We conclude that impaired fibrinolytic potential (raised PAI activity and t-PA antigen) is associated with peripheral atherosclerosis and that this relationship is partly influenced by lipids and cigarette smoking.
Smith
F B
FB
Wolfson Unit for Prevention of Peripheral Vascular Diseases, Department of Public Health Sciences, University of Edinburgh Medical School, UK.
Lee
A J
AJ
Rumley
A
A
Fowkes
F G
FG
Lowe
G D
GD
D000367:Age Factors; D000368:Aged; D001161:Arteriosclerosis / Q000097:blood / Q000453:epidemiology*; D001794:Blood Pressure; D015992:Body Mass Index; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000453:epidemiology*; D015849:Plasminogen Inactivators / Q000097:blood*; D012307:Risk Factors; D012727:Sex Characteristics; D012737:Sex Factors; D012907:Smoking; D010959:Tissue Plasminogen Activator / Q000097:blood*; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008055:Lipids; D015849:Plasminogen Inactivators; D014280:Triglycerides; D002784:Cholesterol; D010959:Tissue Plasminogen Activator