Correlations between fibrinolytic function and acute myocardial infarction

Abstract

The diurnal variation of tissue plasminogen activator and plasminogen activator inhibitor—2 important factors in regulation of fibrinolysis—is well established, but its clinical implications are not yet fully understood. Fibrinolytic function was measured in a group of 133 patients <45 years of age, 3 months after they presented with myocardial infarction, and they were compared with an equal group of carefully matched control subjects. A subsample of 71 patients and 50 control subjects was examined 3 years later. Tissue plasminogen activator inhibitor plasma levels were higher in patients versus control subjects at 3 months and at 3 years after myocardial infarction, with a high degree of correlation between the 2 determinations (r = 0.87). Of all hemostatic parameters studied, only low tissue plasminogen activator activity and increased tissue plasminogen activator inhibitor levels were significantly different between patients with and without recurrent infarction during the 3-year period. In those patients with a second infarction >3 years later, however, tissue plasminogen activator inhibitor concentration was not significantly related to reinfarction.