title: Reduced plasma fibrinolytic capacity as a potential risk factor for a first myocardial infarction in young men.
abstract: Studies on the relationship between fibrinolysis and arterial thrombosis have been conflicting. Previously, we demonstrated that hypofibrinolysis, as measured by a plasma-based assay, increased the risk of venous thrombosis. The present study investigated increased clot lysis time (CLT) measured with the same assay as a risk factor for myocardial infarction in a case-control study including 421 men with a first myocardial infarction and 642 controls below 70 years. CLT was strongly associated with body-mass index, lipid levels, blood pressure and C-reactive protein. Overall, risk of myocardial infarction was 1.4-fold (95% confidence interval (CI) 1.0-1.9) increased for CLT in the fourth quartile (longest CLT) compared with the first quartile. After adjusting for cardiovascular risk factors this risk disappeared (OR 1.0, 95%CI 0.6-1.5). In men aged <50 years the association was pronounced (OR 3.2, 95%CI 1.5-6.7). After adjustment for cardiovascular risk factors the risk was nearly twofold increased (OR 1.8, 95%CI 0.7-4.8). In men aged > or = 50 years, no clear association between CLT and risk of myocardial infarction was found. Our study suggests that hypofibrinolysis increases the risk of a first myocardial infarction in young men, although the causality of this association remains to be determined.
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands.
authors.forename: Mirjam E
authors.initials: ME
authors.lastname: Meltzer
authors.forename: Carine J M
authors.initials: CJ
authors.lastname: Doggen
authors.forename: Philip G
authors.initials: PG
authors.lastname: de Groot
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: Ton
authors.initials: T
authors.lastname: Lisman
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D005342:Fibrinolysis / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D016017:Odds Ratio; D012307:Risk Factors; D010959:Tissue Plasminogen Activator; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator