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Plasminogen activator inhibitor-1 activity and long-term outcome in patients with ST-elevation myocardial infarction

Marin Pavlov1, Vjeran Nikolić-Heitzler, Zdravko Babić

  • 1Marin Pavlov, Department of Cardiology, Sestre Milosrdnice University Hospital Center, Vinogradska cesta 29, 10000 Zagreb, Croatia, marin.pavlov@gmail.com.

Croatian Medical Journal
|July 5, 2018
PubMed

Insights

A significant rise in plasminogen activator inhibitor-1 (PAI-1) activity during ST-elevation myocardial infarction (STEMI) treatment predicts a higher risk of death within five years. This finding aids in stratifying mortality risk for STEMI patients undergoing primary PCI.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Research

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical cardiovascular event.
  • Early identification of patients at high risk for long-term mortality is crucial for effective treatment strategies.
  • Plasminogen activator inhibitor-1 (PAI-1) is a key regulator of fibrinolysis and has been implicated in cardiovascular disease.

Purpose of the Study:

  • To investigate the association between the change in plasminogen activator inhibitor-1 (PAI-1) activity within 24 hours of STEMI treatment and 5-year mortality.
  • To evaluate PAI-1 activity rise as a potential prognostic biomarker in STEMI patients treated with primary percutaneous coronary intervention (PCI).

Main Methods:

  • A prospective cohort study enrolled 87 STEMI patients treated with primary PCI.
  • PAI-1 activity was measured on admission and 24 hours post-treatment.
  • Statistical analyses included ROC curves for predictive value, Cox regression for independent predictors, and linear regression for related covariates.

Main Results:

  • PAI-1 activity rise demonstrated strong predictive value for 5-year mortality (AUC=0.748, optimal cut-off 3.7 U/mL).
  • Patients with PAI-1 activity rise >3.7 U/mL exhibited significantly higher mortality (P<0.001).
  • Independent predictors of death included PAI-1 rise and final Thrombolysis in Myocardial Infarction (TIMI) flow; PAI-1 rise correlated with heart failure, thrombus aspiration, and body weight.

Conclusions:

  • An elevated PAI-1 activity rise (>3.7 U/mL) within 24 hours of primary PCI for STEMI is significantly associated with increased 5-year mortality.
  • PAI-1 activity rise serves as a valuable prognostic marker in STEMI patients.
  • Further research may explore therapeutic targeting of PAI-1 in STEMI management.
Abstract

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