Effect of purified eicosapentaenoate ethyl ester on fibrinolytic capacity in patients with stable coronary artery disease and lower extremity ischaemia.
BACKGROUND
Lower extremity ischaemia is often complicated by coronary artery disease (CAD). Patients with CAD often have impaired fibrinolytic capacity. Plasma plasminogen activator inhibitors (PAI) levels are known to be associated with levels of atherogenic lipids. Purified eicosapentaenoic acid reduces atherogenic lipid levels.


OBJECTIVE
To examine the effect of purified eicosapentaenoic acid ethyl ester (EPA) on the fibrinolytic capacity in patients with stable CAD and arteriosclerosis obliterans (ASO).


METHODS
Plasma levels of PAl activity and tissue-type plasminogen activator (t-PA) antigen were measured. We administered 1800 mg/day EPA for 8 weeks to 25 patients.


RESULTS
Mean baseline plasma PAI activity (P < 0.01) and t-PA antigen (P < 0.01) levels were higher in the patient group than they were in the control group. At the conclusion of EPA administration, significant reductions in PAI activity (P < 0.01), t-PA antigen (P < 0.01) and serum levels of triglyceride (P < 0.01), total (P < 0.05) and low-density lipoprotein (P < 0.05) cholesterols were observed. Changes in PAI activity levels caused by EPA administration showed positive linear correlations with those in low-density lipoprotein cholesterol (r = 0.411, P < 0.05) and triglyceride (r = 0.652, P < 0.01).


CONCLUSIONS
These findings indicate that the fibrinolytic capacity in patients with CAD and ASO is decreased by increased PAI activity, but that EPA may correct this fibrinolytic impairment by decreasing PAI activity via its inhibitory effect on atherogenic lipids.
Tsuruta
K
K
Division of Cardiology, Kumamoto University School of Medicine, Japan.
Ogawa
H
H
Yasue
H
H
Sakamoto
T
T
Miyao
Y
Y
Tanae
H
H
Kaiga
K
K
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000941:Antigens / Q000097:blood; D001162:Arteriosclerosis Obliterans / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D001772:Blood Cell Count; D001786:Blood Glucose / Q000378:metabolism; D003327:Coronary Disease / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015849:Plasminogen Inactivators / Q000097:blood; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D010959:Tissue Plasminogen Activator / Q000097:blood / Q000276:immunology
D000941:Antigens; D001786:Blood Glucose; D008055:Lipids; D015849:Plasminogen Inactivators; D010975:Platelet Aggregation Inhibitors; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid; D010959:Tissue Plasminogen Activator