title: Tissue plasminogen activator and plasminogen activator inhibitor-1 levels in patients with acute myocardial infarction and unstable angina.
abstract: OBJECTIVE
  To compare levels of tissue plasminogen activator and plasminogen activator inhibitor-1 levels in patients with acute myocardial infarction and unstable angina in order to understand the use of high sensitivity C-reactive protein (hsCRP), coagulation and fibrinolysis markers for cardiovascular risk assessment.
  
  
  METHODS
  The cross-sectional case-control study compared circulating concentrations of high sensitivity C reactive protein (hsCRP), fibrinogen, tissue-type plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) between patients of acute myocardial infarction (AMI) (n = 67), Unstable Angina Pectoris (UA) (n = 35) and healthy control subjects (n = 39) at the King Khalid University Hospital, Riyadh, Saudi Arabia, from June 2006 to August 2007.
  
  
  RESULTS
  The patients had significantly higher hsCRP (1.06 +/- 0.11 vs 0.52 +/- 0.14, p < 0.01), fibrinogen (426.21 +/- 24.09 vs 329.32 +/- 13.93, p < 0.05), PAL-1 (44.02 +/- 6.05 vs 19.35 +/- 3.94, p < 0.01) and tPA (12.31 +/- 1.16 vs 9.49 +/- 0.86, p < 0.05) compared to the controls. Fibrinogen (329.32 +/- 13.93) and PAL-1 (19.35 +/- 3.94) were higher in both angina and infarction groups compared to the healthy subjects (p < 0.01). Between the two categories of patients the difference between Fibrinogen (449.60 +/- 52.98 vs 419.46 +/- 23.42) and PAL-1 (52.00 +/- 17.34 vs 43.19 +/- 6.10) levels were non-significant. Also, the difference in tPA levels between the controls and angina patients was nonsignificant (9.49 +/- 0.86 vs 9.91 +/- 1.24 p > 0.05). It was higher in infarction patients (14.79 +/- 3.14) compared to angina patients and the controls, (p < 0.05). Compared to the controls, hsCRP levels were significantly higher in both the patient groups (0.52 +/- 0.14, 1.05 +/- 0.28, 1.40 +/- 0.20, p < 0.01). Moreover, they were significantly higher in infarction patients than those suffering from angina (p < 0.05).
  
  
  CONCLUSIONS
  CAD patients had a procoagulant state and presented with higher levels of hsCRP compared to the healthy individuals. Moreover, there were significant differences in coagulation markers and hsCRP between angina and infarction patients.
authors.affiliation: Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh. shahidhabib44@hotmail.com
authors.forename: Syed Shahid
authors.initials: SS
authors.lastname: Habib
authors.forename: Abdel Galil Mohamad
authors.initials: AG
authors.lastname: Abdel Gader
authors.forename: Mohammad Ibrahim
authors.initials: MI
authors.lastname: Kurdi
authors.forename: Mohammad Owais
authors.initials: MO
authors.lastname: Suriya
authors.forename: Zohair
authors.initials: Z
authors.lastname: Al Aseri
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012529:Saudi Arabia; D010959:Tissue Plasminogen Activator / Q000097:blood*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator