High plasma levels of tPA independently predicted a first acute myocardial infarction with a quartile 4 to 1 ratio of 5.9, while PAI-1 and vWF were also associated with subsequent AMI.
Case-Control (n=234)
Do high plasma levels of PAI-1, tPA, vWF, and TM predict the occurrence of a first acute myocardial infarction?
High plasma levels of PAI-1 and tPA precede and predict the development of a first acute myocardial infarction in both men and women, with tPA being an independent risk marker.
Effect estimate: Ratio 5.9
BACKGROUND: In patients with established ischemic heart disease, prospective cohort studies have indicated that plasminogen activator inhibitor (PAI-1), the inhibitor of the fibrinolytic system, may predict cardiovascular events. So far, there have been no primary prospective studies of PAI-1. METHODS AND RESULTS: The aim of the present study was to test whether plasma levels of PAI-1, tissue-type plasminogen activator (tPA), von Willebrand factor (vWF), and thrombomodulin (TM) could predict the occurrence of a first acute myocardial infarction (AMI) in a population with high prevalence of coronary heart disease by use of a prospective nested case-control design. Mass concentrations of PAI-1 and tPA were significantly higher for the 78 subjects who developed a first AMI compared with the 156 references matched for age, sex, and sampling time; for tPA, this increase was independent of smoking habits, body mass index, hypertension, diabetes, cholesterol, and apolipoprotein A-I. The ratio of quartile 4 to 1 for tPA was 5.9 for a patient to develop a first AMI. The association between tPA and AMI was seen in both men and women. Increased levels of vWF were associated with AMI in a univariate analysis. High levels of TM were associated with AMI in women but not in men. CONCLUSIONS: The plasma levels of PAI-1, tPA, and vWF are associated with subsequent development of a first AMI; for PAI-1 and tPA, this relation was found in both men and women. For tPA but not for PAI-1 and vWF, this association is independent of established risk factors.
Thøgersen et al. (Tue,) conducted a case-control in Acute myocardial infarction (n=234). Plasma levels of PAI-1, tPA, vWF, and TM vs. Matched references was evaluated on Occurrence of a first acute myocardial infarction (AMI) (Ratio 5.9). High plasma levels of tPA independently predicted a first acute myocardial infarction with a quartile 4 to 1 ratio of 5.9, while PAI-1 and vWF were also associated with subsequent AMI.