[Evaluation of the fibrinolytic system in myocardial infarction].
OBJECTIVE
To evaluate the main components of the fibrinolytic system in patients suffering of acute myocardial infarction (AMI), both in the acute phase and once this has been overcome.


METHODS
Components of the fibrinolytic system (i.e., PAI-1, t-PA, fibrinogen, plasminogen, and alpha 2-antiplasmin) were determined in 100 patients with AMI. The studies were performed at AMI and 6 months later, and the findings were compared with those of a control group of 30 people matched with regard to age and sex with the patient group. The statistical analysis of the results was made with the BMPD pack, using Student's t test for comparing quantitative variables and the matched test for paired samples.


RESULTS
At the acute phase the patients showed significant increase of PAI-1 (p < 0.001) and fibrinogen (p < 0.05) concentrations. Plasminogen and alpha 2-antiplasmin rates were lower than in the control group (p < 0.01 and p < 0.005, respectively). In the 6-month study after AMI, significant increase of PAI-1 was found with respect to the control group (p < 0.001). There were also significant differences in the initial PAI-1 rates and the 6-month test (p < 0.05), whereas the increased fibrinogen rates persisted (p < 0.01). Increased antigenic t-PA was found in the patient group before venous occlusion (p < 0.001). Thus, 54 patients (54%) had hypofibrinolysis, due to increased PAI-1 in 41 cases (41%), impaired t-PA release in 13 cases (13%) and both causes in 12 cases (12%).


CONCLUSIONS
Fibrinolytic hypofunction was found in this study during the acute phase of myocardial infarction, which was still present six months later, and was due to increased PAI-1 rates in the majority of the cases.
Moreno
J A
JA
Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario de Zaragoza.
Cornudella
R
R
Gálvez
M
M
Angós
J A
JA
Romero
S
S
Gutiérrez
M
M
D000368:Aged; D003289:Convalescence; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D010958:Plasminogen / Q000032:analysis; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis; D010959:Tissue Plasminogen Activator / Q000032:analysis; D000979:alpha-2-Antiplasmin / Q000032:analysis
D017395:Plasminogen Activator Inhibitor 1; D000979:alpha-2-Antiplasmin; D005340:Fibrinogen; D010958:Plasminogen; D010959:Tissue Plasminogen Activator
Valoración del sistema fibrinolítico en el infarto de miocardio.