The role of the fibrinolytic system in acute myocardial infarction after a normal exercise test

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K Sakata1, C Kurata, T Taguchi

  • 1Third Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.

European Heart Journal
|December 1, 1989
PubMed

Insights

High free plasminogen activator inhibitor-1 (PAI-1) antigen levels before myocardial infarction may indicate a heightened risk. Impaired fibrinolysis during ischemia in these patients suggests a strong tendency for acute myocardial infarction.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Acute myocardial infarction (AMI) involves coronary artery thrombosis.
  • Fibrinolytic system components play a crucial role in clot lysis.
  • Plasminogen activator inhibitor-1 (PAI-1) is a key regulator of fibrinolysis.

Observation:

  • A patient with AMI showed significantly elevated total PAI-1 antigen, primarily free PAI-1, prior to the event.
  • During ischemia, plasminogen activator activity was suppressed.
  • This suppression was linked to reduced tissue plasminogen activator antigen release and increased PAI activity.

Findings:

  • Basal high levels of free PAI-1 antigen were observed before AMI onset.
  • Ischemia led to further suppression of fibrinolytic activity in this patient.
  • The findings suggest a potential link between high basal free PAI-1 and AMI risk.

Implications:

  • Patients with coronary artery disease and high basal free PAI-1 may be predisposed to AMI.
  • Impaired fibrinolysis under ischemic conditions could be a contributing factor.
  • Monitoring free PAI-1 may aid in identifying individuals at higher risk for AMI.

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