Plasminogen Activator Inhibitor-1 Levels in Heart Failure Patients: A Cross-sectional Study

Introduction: Heart Failure (HF) is a worldwide health concern and a major cause of morbidity and mortality globally. Among the numerous biomarkers associated with HF, Plasminogen Activator Inhibitor-1 (PAI-1) has received attention for its role in poor fibrinolysis and thrombosis. Aim: This study aimed to compare serum PAI-1 levels in patients diagnosed with HF to those of healthy participants. Materials and Methods: This cross-sectional study was conducted in the Department of Biochemistry, in collaboration with the Department of Medicine at Sri Guru Ram Das Hospital, Amritsar, Punjab, India. The study comprised 50 individuals with confirmed HF from the inpatient department of the Medicine Department and 50 healthy individuals of comparable age, conducted from October 2019 to December 2023. Serum levels of PAI-1, N-terminal proB-type Natriuretic Peptide (NT-proBNP), Brain Natriuretic Peptide (BNP), creatinine, and Urine Albumin-to-Creatinine Ratio (UACR) were investigated and compared. The data were statistically analysed and presented as mean and standard deviation (SD). Odds ratio and Student’s t-test were performed. Results: The study included 100 participants, with a mean age of 62.3±10.4 years, comprising 68% males and 32% females, ensuring age and gender representation across both HF patients and healthy controls. The mean±SD of serum PAI-1 was 10.09±1.68 ng/mL in healthy individuals and 35.16±11.14 ng/mL in HF patients, indicating that PAI-1 could be a valuable indicator for diagnosing HF. A comparison with healthy controls showed significantly higher levels of PAI-1 (p < 0.001) in HF patients. PAI-1 had a significantly high odds ratio (OR) (585.8, 95% CI: 32.5-10554.5), showing a strong association. Furthermore, as the condition became more severe, the levels of these biomarkers increased significantly. Conclusion: Serum levels of PAI-1 are significantly associated with HF, indicating that they could be used for the identification of HF. Further studies are required to validate these findings and evaluate the clinical benefit of targeting PAI-1 in HF management.