title: Depression of factor XII-dependent fibrinolytic activity in survivors of acute myocardial infarction at risk of reinfarction.
abstract: Defective fibrinolysis may constitute a risk for the development of myocardial infarction in patients with ischaemic heart disease. We studied prospectively the factor XII-dependent plasminogen proactivator system in 49 survivors of an acute myocardial infarction. Blood samples were collected 8 weeks after hospital discharge. The factor XII-dependent fibrinolytic activity in the specimens was determined on fibrin plates after complete immuno-inhibition of the urokinase-like and the t-PA related fibrinolytic systems. During the subsequent follow-up period of 2.4 years, 10 patients developed recurrent myocardial infarction, whereas the remaining 39 patients did not. The reinfarction group of patients had a significantly lower median factor XII-dependent fibrinolytic activity (24.9 blood activating units (BAU).ml-1) than the patients without a relapse (41.9 BAU.ml-1, P < 0.02). Plasma concentrations of factor XII did not deviate significantly between the groups (P > 0.05), whereas the median plasma concentrations of prekallikrein was slightly lower in the reinfarction group (90%) than in the non-reinfarction group of patients (105%, P < 0.02). These observations point to an association between a depressed factor XII-dependent fibrinolytic activity and an enhanced risk of reinfarction in patients with a previous episode of acute myocardial infarction.
authors.affiliation: Department of Clinical Chemistry, Ribe County Hospital in Esbjerg, Denmark.
authors.forename: O D
authors.initials: OD
authors.lastname: Pedersen
authors.forename: S
authors.initials: S
authors.lastname: Munkvad
authors.forename: J
authors.initials: J
authors.lastname: Gram
authors.forename: C
authors.initials: C
authors.lastname: Kluft
authors.forename: J
authors.initials: J
authors.lastname: Jespersen
mesh_terms: D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D005174:Factor XII / Q000502:physiology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D011288:Prekallikrein / Q000502:physiology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D013917:Thrombin / Q000502:physiology; D014280:Triglycerides
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D005174:Factor XII; D011288:Prekallikrein; D002784:Cholesterol; D013917:Thrombin