Related Experiment Videos
Plasma t-PA/PAI-1 complex and blood coagulability in patients with coronary artery disease
K Yamauchi1, T Suzuki, T Furumichi
1First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Insights
This study found that patients with coronary artery disease (CAD) exhibit increased blood coagulability, indicated by higher levels of tissue-type plasminogen activator/plasminogen activator inhibitor-1 (t-PA/PAI-1) complex. This coagulability is linked to the severity of CAD.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Thrombosis Research
Background:
- The clinical significance of the tissue-type plasminogen activator/plasminogen activator inhibitor-1 (t-PA/PAI-1) complex in chronic ischemic heart disease remains unclear.
- The t-PA/PAI-1 complex is recognized as an indicator of fibrinolysis activator and inhibitor release from the vascular wall.
Purpose of the Study:
- To investigate the plasma levels of t-PA, PAI-1, and the t-PA/PAI-1 complex in patients with coronary artery disease (CAD).
- To assess the relationship between these markers and the severity of CAD.
Main Methods:
- Plasma levels of t-PA, PAI-1, t-PA/PAI-1 complex, fibrinogen, factor VII, factor VIII, von Willebrand factor (vWF) antigen, and thrombin-antithrombin III complex were measured.
- 72 CAD patients (subdivided by vessel disease severity) and 29 control subjects were analyzed.
Main Results:
- Triple-vessel disease patients showed higher fibrinogen, factor VII activity, and t-PA antigen levels compared to controls.
- Patients with double- and triple-vessel disease exhibited elevated levels of factor VIII, vWF antigen, thrombin-antithrombin III complex, and t-PA/PAI-1 complex.
- t-PA/PAI-1 complex levels significantly correlated with factors VII, VIII, and thrombin-antithrombin III complex.
Conclusions:
- Patients with CAD demonstrate increased blood coagulability compared to controls.
- The observed increase in coagulability is directly related to the severity of coronary artery disease.
Abstract:
The t-PA/PAI-1 complex is a good indicator of the release of fibrinolysis activators and inhibitors from the vascular wall, but its clinical significance in chronic ischemic heart disease is unclear. The plasma levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), and the t-PA/PAI-1 complex (including various coagulation factors) were assayed in 72 patients with coronary artery disease (CAD) and 29 control (C) subjects. The CAD patients were subdivided into 3 groups: single-vessel disease (G1, n = 30), double-vessel disease (G2, n = 20), and triple-vessel disease (G3, n = 22). The patients with triple-vessel disease had higher fibrinogen values (G3: 318 +/- 75 mg/dl, C: 263 +/- 56), factor VII activity (G3: 143 +/- 36%, C: 123 +/- 14), and t-PA antigen levels (G3: 4.7 +/- 0.8 ng/ml, C: 3.3 +/- 0.7) than controls. Patients with double- and triple-vessel disease also showed higher levels of factor VIII, vWF antigen, thrombin-antithrombin III complex (G1: 2.3 +/- 0.6 ng/ml, G2: 2.7 +/- 0.5, G3: 3.1 +/- 0.5, C: 2.0 +/- 0.5), and t-PA/PAI-1 complex (G1: 13.9 +/- 6.1 ng/ml, G2: 16.4 +/- 4.6, G3: 18.2 +/- 5.9, C: 10.7 +/- 4.9) than control subjects. The t-PA/PAI-1 complex levels were correlated significantly with the activities of factors VII and VIII and the thrombin-antithrombin III complex. These findings suggest that patients with CAD have greater blood coagulability than controls, and that this difference is related to the severity of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)