Pretreatment plasminogen activator inhibitor-1 (PAI-1) levels and the outcome of thrombolysis with streptokinase in patients with acute myocardial infarction.
BACKGROUND
The risk for reinfarctions and delays in reperfusion after streptokinase therapy may be caused by the antifibrinolytic effect of platelet-derived type 1 plasminogen activator inhibitor (PAI-1). This study aims to show the relation of pretreatment PAI-1 levels of patients with acute myocardial infarction treated with streptokinase therapy and the outcome of fibrinolysis, with the emphasis on reperfusion and reinfarction.


METHODS
Pretreatment PAI-1 levels of 60 patients with acute myocardial infarction, treated with streptokinase, were determined by the chromogenic method. Failure of thrombolysis with streptokinase was present when reperfusion was delayed as assessed by noninvasive reperfusion criteria, or reinfarctions developed.


RESULTS
Mean pretreatment PAI-1 level of patients was 6.3+/-1.2 U/ml; span 1.2 U/ml to 34.0 U/ml. Thrombolysis with streptokinse failed significantly in patients with pretreatment PAI-1 levels >4.0 U/ml (p < 0.05), mainly because of significant occurrence of reinfarction (p < 0.05), but less to delayed reperfusion (p > 0.05).


CONCLUSIONS
Failure of thrombolysis with streptokinase is significantly associated with pretreatment PAI-1 levels of >4.0 U/ml.
Sinkovic
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A
Department for Internal Intensive Medicine, Teaching Hospital Maribor, Slovenia.
D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D017395:Plasminogen Activator Inhibitor 1; D013300:Streptokinase