Imbalance of plasminogen activator inhibitor-I/ tissue plasminogen activator and tissue factor/tissue factor pathway inhibitor in young Japanese men with myocardial infarction.
To evaluate the association between haemostatic parameters and increased risk of myocardial infarction (MI) at a young age, we measured fibrinogen, factor VII, antithrombin III, protein C, protein S, tissue factor (TF), free form tissue factor pathway inhibitor (TFPI), plasminogen, alpha2-antiplasmin, tissue plasminogen activator (tPA), plasminogen activator inhibitor-I (PAI-I), and lipoprotein (a) in 140 young men with MI before age 45 and 150 age-matched healthy men. TF, TF/TFPI ratio, PAI-I, PAI-I/tPA ratio, plasminogen, and lipoprotein (a) in young MI patients were all significantly higher than controls, while TFPI, antithrombin II, and tPA were significantly lower (P <0.001 of each). Significant determinants of MI risk were PAI-I/tPA ratio (R2 = 0.300, P <0.001), TF/TFPI ratio (R2 = 0.049, P <0.001), antithrombin III (R2 = 0.034, P <0.001), hyperlipidaemia (R2 = 0.019, P = 0.004), diabetes (R2 = 0.014, P = 0.015), lipoprotein (a) (R2 = 0.012, P = 0.023), alpha2-antiplasmin (R2= 0.014, P = 0.012), and protein C (R2= 0.012, P = 0.018). We conclude that the imbalances of PAI-I/tPA and TF/TFPI are significantly associated with MI at a young age, perhaps mediated via impaired fibrinolytic activity.
Saigo
M
M
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Abe
S
S
Ogawa
M
M
Yamashita
T
T
Biro
S
S
Minagoe
S
S
Maruyama
I
I
Tei
C
C
D000328:Adult; D001779:Blood Coagulation Factors / Q000378:metabolism* / Q000502:physiology; D016022:Case-Control Studies; D006487:Hemostasis; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007564:Japan; D008074:Lipoproteins / Q000097:blood / Q000502:physiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood / Q000502:physiology; D012307:Risk Factors; D013925:Thromboplastin / Q000378:metabolism / Q000502:physiology; D010959:Tissue Plasminogen Activator / Q000097:blood / Q000502:physiology
D001779:Blood Coagulation Factors; D008074:Lipoproteins; D017395:Plasminogen Activator Inhibitor 1; C051928:lipoprotein-associated coagulation inhibitor; D013925:Thromboplastin; D010959:Tissue Plasminogen Activator