[The fibrinolytic system in patients with dilated myocardiopathy].
OBJECTIVE
To study the fibrinolytic system in dilated cardiomyopathy (DCM) patients, and the relationship between the degree of severity (NYHA degree), and the presence of complications (atrial fibrillation, intracavity thrombus, and peripheral embolism). We also analyzed the influence of the antithrombotic therapy on the fibrinolysis's proteins.


METHODS
We included 18 patients, stratified in two etiologic groups: 9 with idiopathic and 9 with ethyl DCM. The fibrinolytic system was investigated through the plasma levels of antigenic and functional t-PA and PAI-1. We also carried out a venous occlusion test to investigate the fibrinolytic the fibrinolytic activity in t-PA secretion. The clinical aspects were recorded. We included 30 healthy individuals matched for age and sex, as controls.


RESULTS
The antigenic levels of t-PA and PAI-1, were significantly higher in the DCM group than in the control group (p < 0.01). The venous occlusion test responses were normal. No relationship between the fibrinolytic parameters and clinical data were observed.


CONCLUSIONS
The high levels of antigenic t-PA found in DCM patients were considered as a vascular injury marker, and a atherothrombotic risk factor. Furthermore, there is a hypofibrinolytic condition shown by a PAI-1 augmentation. In conclusion, we are prone to consider long term oral anticoagulation in the management of DCM patients.
Fernández
P
P
Unidad de Trombosis y Hemostasia, Hospital General Universitario de Alicante.
Marín
F
F
Marco
P
P
Roldán
V
V
García
M C
MC
Martínez
J G
JG
Sogorb
F
F
Calatayud
R
R
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology; D002310:Cardiomyopathy, Alcoholic / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D003250:Constriction; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006331:Heart Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012307:Risk Factors; D012720:Severity of Illness Index; D013923:Thromboembolism / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D013927:Thrombosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000097:blood*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D017395:Plasminogen Activator Inhibitor 1; D010959:Tissue Plasminogen Activator