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Related Experiment Videos

Thrombotic markers during myocardial infarction

S Ferlito1, M Gallina, S Mangiameli

  • 1Institute of I Medical Clinics, University of Catania, Italy.

Panminerva Medica
|September 1, 1995
PubMed
Summary

This study on myocardial infarction patients found reduced plasminogen activator inhibitor-1 (PAI-1) and D-dimer levels two weeks post-event. These findings suggest a pre-existing hypofibrinolytic state may contribute to thrombotic events.

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Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Acute myocardial infarction (MI) involves complex thrombotic processes.
  • Understanding the behavior of molecular markers during MI is crucial for diagnosis and treatment.
  • Previous research indicates alterations in coagulation and fibrinolysis markers post-MI.

Purpose of the Study:

  • To investigate the dynamic changes of thrombotic markers in patients with acute myocardial infarction.
  • To assess the role of specific markers like fibrinogen, t-PA, PAI-1, D-dimer, FPA, and BTG in the acute and post-acute phases of MI.
  • To identify potential pathogenetic mechanisms contributing to thrombotic events in MI.

Main Methods:

  • Study included 12 patients (6 males, 6 females) with acute MI.

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  • Blood samples were collected at symptom onset (pre-thrombolysis) and two weeks post-MI.
  • Plasma levels of fibrinogen (F), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), D-dimer (D-D), fibrinopeptide A (FPA), and betathromboglobulin (BTG) were measured using coagulative and ELISA methods.

    • Main Results:

    • Tissue plasminogen activator (t-PA), fibrinopeptide A (FPA), and betathromboglobulin (BTG) showed no significant variations.
    • A significant reduction in plasminogen activator inhibitor-1 (PAI-1) was observed two weeks post-MI (4.6 +/- 0.28 UI/ml vs 5.4 +/- 0.33 UI/ml, p < 0.01).
    • Significant reductions in D-dimer (215 +/- 10 ng/ml vs 253 +/- 12 ng/ml, p < 0.05) and a significant increase in fibrinogen (F) (294 +/- 28 mg% vs 218 +/- 16 mg%, p < 0.05) were noted post-MI.

    Conclusions:

    • A basal reduction in fibrinolytic activity, indicated by elevated PAI-1, may play a significant pathogenetic role in thrombotic events.
    • Markers like t-PA, FPA, and BTG appear to be of secondary importance, showing alterations only in the initial phase.
    • A pre-infarctual hypofibrinolytic condition, potentially triggered by specific factors, is suggested as the primary prothrombotic state requiring intervention through diet and medication.