Related Experiment Videos
Plasma protein C inhibitor is elevated in survivors of myocardial infarction
V A Carroll1, M R Griffiths, M Geiger
1Department of Vascular Biology and Thrombosis Research, University of Vienna, Technoclone Inc., Austria.
Insights
Elevated levels of protein C inhibitor (PCI), a key fibrinolytic inhibitor, were observed in myocardial infarction survivors. Higher PCI levels correlate with increased acute coronary events, suggesting PCI as a potential risk marker for cardiovascular disease.
Area of Science:
- Cardiovascular Medicine
- Hemostasis and Thrombosis
- Biochemistry
Background:
- Atherosclerotic disease involves alterations in hemostatic and fibrinolytic systems.
- Plasminogen activator inhibitor-1 (PAI-1) is a commonly studied inhibitor.
- Previous studies identified fibrinogen, von Willebrand factor antigen, and tissue plasminogen activator antigen as risk markers for acute coronary events.
Purpose of the Study:
- To evaluate the fibrinolytic system in coronary artery disease patients.
- To investigate the role of plasminogen activator inhibitor-3 (PAI-3), also known as protein C inhibitor (PCI), in coronary artery disease.
- To determine if PCI levels are associated with acute coronary events or disease severity.
Main Methods:
- Investigated hemostatic and fibrinolytic parameters in 115 male survivors of myocardial infarction.
- Compared these parameters with 87 age-matched healthy male control subjects.
- Measured PCI active antigen levels and correlated them with clinical outcomes and coronary angiography findings.
Main Results:
- PCI active antigen was significantly elevated in the myocardial infarction group compared to controls (P < .03).
- Elevated PCI levels were associated with the number of acute coronary events (P = .005).
- PCI levels did not correlate with the severity of coronary artery disease as assessed by angiography.
Conclusions:
- Elevated plasma PCI levels are a potential risk marker for acute coronary events.
- PCI may play a significant role in the pathogenesis of atherosclerotic disease.
- PCI's interference with both anticoagulant and fibrinolytic systems highlights its importance in cardiovascular events.
Abstract:
Many studies have shown alterations of the hemostatic and fibrinolytic systems in patients with atherosclerotic disease, principally in levels of plasminogen activator inhibitor-1. However, in a large prospective study only fibrinogen, von Willebrand factor antigen, and tissue plasminogen activator antigen were found to be independent risk markers for acute coronary events. The present study evaluated the fibrinolytic system in coronary artery disease, paying particular attention to another inhibitor of fibrinolysis, plasminogen activator inhibitor-3, also called protein C inhibitor (PCI). One hundred fifteen nonanticoagulated male survivors of myocardial infarction were investigated for a range of hemostatic and fibrinolytic parameters that were compared with values in 87 age-matched healthy control male subjects. PCI active antigen was significantly (P < .03) elevated in the myocardial infarction group compared with the control group and was associated with the number of acute coronary events suffered (P = .005) but not with the severity of disease as determined by coronary angiography. Elevated PCI plasma levels can be considered as a risk marker for acute coronary events and might be of particular importance in the pathogenesis of this disease due to the interference of PCI in both the anticoagulant and fibrinolytic systems.