High levels of vWF and t-PA, and low DHEAS, predicted cardiovascular mortality among 123 survivors of myocardial infarction, with 54 cardiovascular deaths occurring over 10 years.
Cohort (n=123)
BACKGROUND: Haemostasis plays a major part in the process initiating a myocardial infarction. The impact of haemostatic variables on long term prognosis is unknown. OBJECTIVE: To evaluate von Willebrand factor (vWF), tissue plasminogen activator antigen (t-PA) and its activity before and after venous occlusion, plasminogen activator inhibitor (PAI-1), dehydroepian-drosterone sulphate (DHEAS), and established clinical risk factors as long term predictors for reinfarction and mortality. PATIENTS: 123 consecutive survivors of myocardial infarction followed up for 10 years. DESIGN: Study entry took place between 1982 and 1983. Fifty seven patients died (54 of cardiovascular disease) during the mean observation time of 10 years. RESULTS: Cox's univariate regression analysis showed that cardiovascular mortality was significantly associated with age, hypertension, previous history of angina pectoris, DHEAS, mass concentration of t-PA, and vWF. These associations were significant for vWF and mass concentration of t-PA after adjusting for age and hypertension. CONCLUSIONS: A low concentration of DHEAS and high levels of the endothelially derived haemostatic variables vWF and mass concentration of t-PA are predictors of cardiovascular mortality in survivors of myocardial infarction. This association is independent of established clinical risk factors for mass concentration of t-PA and vWF.
Jansson et al. (Thu,) conducted a cohort in acute myocardial infarction (n=123). vWF, t-PA, and DHEAS levels was evaluated on reinfarction and mortality. High levels of vWF and t-PA, and low DHEAS, predicted cardiovascular mortality among 123 survivors of myocardial infarction, with 54 cardiovascular deaths occurring over 10 years.