Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Evidence for increased levels of plasminogen activator inhibitor and tissue plasminogen activator in plasma of patients with angiographically verified coronary artery disease
Departments of Internal Medicine and Clinical Chemistry, Umea University Hospital S-90185 Umea Sweden
Received 14 June 1988; revised 26 July 1988; .
Address for correspondence Dr T. Nilsson, Central Laboratory, Skelleftea Hospital, S-93186 Skelleftea, Sweden.
Abstract
We studied 234 consecutive patients who underwent coronary angiography because of severe angina pectoris. Tissue plasminogen activator (tPA), plasminogen activator inhibitor (PA1), and lipoprotein Lp(a) were measured in citratedplasma samples. The 214 patients showing significant coronary artery stenosis (>50% reduction of luminal area in any of the great coronary arteries) had higher mean levels of tPA (P <0.001) and PAI (P <0.01) than a random population sample of similar age. PAI and tPA levels were higher in smokers than in either non-smokers or ex-smokers, and in patients with hypertension tPA was increased. Subjects with blood group A had a higher mean Lp(a) level than subjects with blood group O. There were positive correlations of PAI and tPA levels with serum triglycerides and with body mass index; Lp(a) correlated weakly with plasma fibrinogen concentrations. The findings suggest an impairment of the fibrinolytic system in patients with coronary artery disease, which offers a link between established risk factors and a plausible pathophysiological mechanism, namely thrombus turnover.
Key Words: Coronary artery disease • Fibrinolysis • tissue plasminogen activator • plasminogen activator inhibitor • lipoprotein Lp(a)
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