Elevated tissue plasminogen activator in patients with screening-detected abdominal aortic aneurysm.
OBJECTIVE
A population-based case-control study with historical and current data was conducted in a population with a high prevalence of disease to explore the hypothesis that the fibrinolytic system may be involved in the early pathogenesis of abdominal aortic aneurysm (AAA).


METHODS
Forty-two patients found to have AAA at population-based screening were compared with 100 controls matched for age and sex. Mass concentration of tissue plasminogen activator (tPA mass) and tissue plasminogen activator/plasminogen activator inhibitor-1 complex (tPA/PAI-1 complex mass) were analyzed in blood samples obtained at the screening (current), and in blood samples obtained from a study conducted 12 years previously on the same population (historical).


RESULTS
Current tPA mass levels were significantly higher in AAA patients compared with controls (13.6 vs 11.4 microg/L, P=.016). A similar trend was observed in historical tPA mass levels (9.8 vs 8.2 microg/L, P=.062). Current and historical mass concentrations of tPA/PAI complex in AAA patients were similar to those in controls. Current tPA mass levels retained the associations with AAA in a logistic regression model after adjustment for history of atherosclerosis (odds ratio [OR], 1.1 per microg/L, P=.039) and current smoking (OR 1.1 per microg/L, P=.039). When family history of AAA was added in a logistic regression model, the OR for current tPA mass was 1.1 per microg/L (P=.056) and 1.1 per microg/L (P=.070) when treated hypertension was added.


CONCLUSIONS
The finding of elevated tPA mass, in contrast to tPA/PAI-1 complex, in plasma among patients with screening-detected AAA supports the hypothesis that the fibrinolytic system may be important in the early pathogenesis of AAA.
Wanhainen
Anders
A
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden. andwan@algonet.se
Nilsson
Torbjörn K
TK
Bergqvist
David
D
Boman
Kurt
K
Björck
Martin
M
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D050197:Atherosclerosis / Q000150:complications; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D016017:Odds Ratio; D010375:Pedigree; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D010959:Tissue Plasminogen Activator / Q000097:blood*; D015854:Up-Regulation
D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D010959:Tissue Plasminogen Activator