The relationship of plasminogen activator inhibitor-1 levels to the ST deviation pattern of acute myocardial infarction.
OBJECTIVE
Myocardial infarction (MI) may be classified as ST elevation MI (STEMI) or non-ST elevation MI (NSTEMI). Procoagulants such as plasminogen activator inhibitor-1 (PAI-1) as well as markers of inflammation such as C-reactive protein (CRP), serum amyloid A (SAA) and interleukin-6 (IL-6) are elevated in acute coronary syndromes. However, no study has examined whether levels of these markers differ in patients with STEMI as opposed to NSTEMI. We sought to determine whether there are differences in plasma levels of PAI-1, CRP, SAA or IL-6 in patients with STEMI compared to patients with NSTEMI.


METHODS
Seventy-six consecutive patients presenting with acute MI (37 with STEMI and 39 with NSTEMI) were prospectively enrolled. Blood samples were obtained from patients within 6 h from presentation and plasma PAI-1, CRP, IL-6 and SAA concentrations were measured.


RESULTS
Plasma levels of PAI-1 were significantly higher in patients with STEMI compared to NSTEMI: 85.7 +/- 5 vs. 61.3 +/- 5 ng/ml (p < 0.001), while CRP, SAA and IL-6 levels were not significantly different between STEMI and NSTEMI patients.


CONCLUSIONS
Higher plasma PAI-1 levels in STEMI patients may contribute to the predilection of these patients to occlusive thrombi and STEMI.
Rott
David
D
Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. drott@012.net.il
Leibowitz
David
D
Finci-Yeheskel
Zvezdana
Z
Barak
Vivian
V
Chajek-Shaul
Tova
T
Weiss
Teddy
T
Levin
Mark
M
Urieli-Shoval
Simcha
S
D000209:Acute-Phase Proteins / Q000378:metabolism; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000378:metabolism; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000378:metabolism*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011237:Predictive Value of Tests; D000685:Serum Amyloid A Protein / Q000378:metabolism
D000209:Acute-Phase Proteins; C508600:IL6 protein, human; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein