title: Plasminogen activator inhibitor-1 in patients with atrial arrhythmias during acute myocardial infarction, treated with streptokinase.
abstract: Atrial arrhythmias (AA), especially atrial fibrillation (AF), during acute myocardial infarction (AMI) are often associated with increased mortality and heart failure. Impaired fibrinolysis with elevated plasminogen activator inhibitor-1 (PAI-1) activity is associated with resistance to fibrinolytic therapy in AMI patients, but it is also found in patients with AF. Our aim was a prospective study of the role of pre-treatment PAI-1 levels for the presence of AA in AMI patients and the influence of AA on in-hospital mortality. In 116 AMI patients, treated with streptokinase, pre-treatment PAI-1 levels were estimated by the chromogenic method (normal levels, 0.3-3.5 U/ml) and in-hospital AA were assessed as atrial fibrillation, flutter and/or tachycardias. Between patients with and without AA, a significant difference was observed in mean pre-treatment PAI-1 levels, in several in-hospital complications and mortality (24 versus 4.4%; P < 0.01; odds ratio, 6.45; 95% confidence interval, 1.66-25.0). The PAI-1 level > 7 U/ml was the most significant independent pre-treatment risk factor for AA (P < 0.05; odds ratio, 3.5; 95% confidence interval, 1.15-10.6). We conclude that AA were a significant risk for in-hospital mortality of AMI patients, treated with streptokinase. A pre-treatment PAI-1 level > 7 U/ml was the most significant pre-treatment risk for AA in these patients.
authors.affiliation: Department for Internal Intensive Medicine, General Hospital Maribor, Slovenia. andreja.sinkovic@guest.arnes.si
authors.forename: A
authors.initials: A
authors.lastname: Sinkovic
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013300:Streptokinase / Q000627:therapeutic use*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D013300:Streptokinase