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Plasminogen activator and plasminogen activator inhibitor activities in men with coronary artery disease
A Oseroff1, C Krishnamurti, A Hassett
1Division of Cardiology, Walter Reed Army Medical Center, Washington, D.C. 20307-5100.
Insights
This study found no link between plasminogen activator inhibitor-1 (PAI-1) or tissue-type plasminogen activator (t-PA) levels and coronary artery disease in men. These findings suggest PAI-1 and t-PA may not be reliable biomarkers for assessing CAD risk.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biochemistry
Background:
- Elevated plasminogen activator inhibitor-1 (PAI-1) is linked to myocardial infarction, but its association with coronary artery disease (CAD) remains debated.
- Tissue-type plasminogen activator (t-PA) is a key fibrinolytic enzyme, and its interaction with PAI-1 is crucial in regulating clot breakdown.
Purpose of the Study:
- To investigate the association between angiographically confirmed coronary artery disease severity and plasma levels of PAI-1 and t-PA.
- To explore correlations between PAI-1, t-PA, and other cardiovascular risk factors like triglycerides and high-density lipoprotein (HDL).
Main Methods:
- Sixty-five men aged 35-65 without prior cardiovascular events were assessed for CAD severity via angiography.
- Plasma PAI-1 and t-PA activities were measured before and after venous occlusion.
- Patients were categorized into five groups based on coronary atherosclerosis extent, from normal to severe (≥50% occlusion in three vessels).
Main Results:
- PAI-1 activity showed an inverse correlation with t-PA activity and a positive correlation with triglycerides.
- A significant negative correlation was observed between PAI-1 activity and HDL levels.
- No significant differences in mean PAI-1 or t-PA activity were found across the five CAD severity groups or compared to healthy controls.
Conclusions:
- The study indicates no association between PAI-1 or t-PA activities and the presence or severity of coronary artery disease in this cohort of men.
- These findings challenge the role of PAI-1 and t-PA as direct biomarkers for coronary atherosclerosis in this specific population.
Abstract:
Although elevated levels of plasminogen activator inhibitor-1 (PAI-1) have been associated with the development of myocardial infarction, the correlation between the presence of coronary artery disease and increased levels of PAI-1 is controversial. The present study evaluated the association between angiographically-documented coronary artery disease and plasma levels of PAI-1 and tissue-type plasminogen activator (t-PA) in 65 men (ages 35 to 65 years) who had no previous history of myocardial infarction, angioplasty, or other medical illnesses. PAI-1 activity in these 65 patients was inversely correlated with t-PA activity, which was measured before and after venous occlusion. PAI-1 activity correlated positively with levels of triglycerides. There was a significant negative correlation between PAI-1 activity and levels of high-density lipoprotein. Each patient was placed in one of five groups according to the severity of coronary atherosclerosis, which ranged from normal vessels (group I) to greater than 50% occlusion of three vessels (group V). There were no significant differences among the five groups with respect to mean activity of PAI-1 (p = 0.98) or t-PA activity measured before venous occlusion (p = 0.22) or after occlusion (p = 0.70). T-PA and PAI-1 activities in these five groups were not different from those in 35 healthy men. These data indicate that there is no association between activities of PAI-1 or t-PA and coronary artery disease in this well-characterized male population.