Hemostatic and fibrinolytic parameters in survivors of myocardial infarction: a low plasma level of plasmin-alpha2-antiplasmin complex is an independent predictor of coronary re-events.
Abnormalities of coagulation or fibrinolysis play a role in the pathogenesis of coronary artery disease (CAD). Elevated plasma levels of fibrinogen, von Willebrand factor antigen, plasminogen activator inhibitor-1 and tissue-type plasminogen activator were reported to be predictive for reinfarction and death in patients with CAD. We investigated the risk for coronary re-events associated with 18 hemostatic and fibrinolytic parameters in a prospective study including 200 survivors of myocardial infarction (MI). During a 2-year follow-up, 37 patients suffered one of the following predefined re-events: fatal MI (n = 2), non-fatal MI (n = 5), percutaneous transluminal coronary angioplasty (n = 17) or coronary artery bypass grafting (n = 13). Low plasmin-alpha2-antiplasmin complex (PAP) plasma levels were associated with an up to fivefold (95% confidence interval, 1.6-15.3) increase in relative risk. The association between decreasing PAP levels and coronary re-events remained significant (P = 0.004) after correction for possible confounders using multiple logistic regression analysis. Our data indicate low PAP plasma levels to be associated with subsequent coronary events in patients with a history of MI.
Central Hematology Laboratory, University Hospital Bern, Switzerland.
M
M
Redondo
V A
VA
Carroll
T
T
Mauron
F D
FD
Biasiutti
B R
BR
Binder
B
B
Lämmle
W A
WA
Wuillemin
D000328:Adult; D000368:Aged; D000933:Antifibrinolytic Agents; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000235:genetics / Q000378:metabolism; D018572:Disease-Free Survival; D005165:Factor V / Q000235:genetics; D005260:Female; D005341:Fibrinolysin / Q000378:metabolism; D005343:Fibrinolytic Agents / Q000378:metabolism*; D005500:Follow-Up Studies; D006490:Hemostatics / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy*; D017354:Point Mutation; D011446:Prospective Studies; D011516:Prothrombin / Q000235:genetics; D012008:Recurrence; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000933:Antifibrinolytic Agents; D015415:Biomarkers; D001779:Blood Coagulation Factors; D005343:Fibrinolytic Agents; D006490:Hemostatics; D000979:alpha-2-Antiplasmin; C095381:factor V Leiden; C037742:plasmin-plasmin inhibitor complex; D005165:Factor V; D011516:Prothrombin; D005341:Fibrinolysin