The acute release of PAI-1 over the first 24 hours of STEMI was significantly higher in patients who died at 30 days compared to survivors (46.9 vs -0.6 ng/mL, P=0.0001).
Observational (n=153)
Does the acute release of PAI-1 and vWF predict 30-day mortality and heart failure in patients with STEMI?
The acute rise of PAI-1 over the first 24 hours in STEMI patients is a strong independent predictor of 30-day mortality and heart failure.
p-value: p=0.0001
BACKGROUND: A few studies have suggested that von Willebrand factor (vWF) or plasminogen activator inhibitor-1 (PAI-1) can be associated with outcomes of acute coronary syndromes. The present study was designed to assess the acute release of these markers in ST-segment elevation myocardial infarction (STEMI) and their relations to death. METHODS AND RESULTS: In 153 consecutive patients with STEMI, vWF and PAI-1 antigens were measured on admission (H0) and 24 hours later (H24). At 30 days, the death rate was 7.2%. Heart failure (Killip stage > or =3) on admission was present in 13.7% of patients. The acute release of PAI-1 (H24-H0, in ng/mL) and of vWF (H24-H0, in %) was dramatically higher in patients who died than in those who survived (46.9+/-26.3 versus -0.6+/-2.8 ng/mL, P=0.0001 and 65.8+/-20.0% versus 10.0+/-5.1%, P=0.004 for PAI-1 and vWF, respectively) and in patients developing heart failure compared with those without (24.8+/-10.1 versus -1.1+/-3.3 ng/mL, P=0.004 and 47.3+/-11.0% versus 8.1+/-5.6%, P=0.005 for PAI-1 and vWF, respectively). The release of PAI-1 correlated weakly with the left ventricular ejection fraction (R=-0.195, P=0.01) and the peak of troponin (R=0.149, P=0.045). Postangioplasty TIMI-3 flow and the acute release of PAI-1 were the only 2 independent predictors of death at 30 days. CONCLUSIONS: The acute release of vWF and PAI-1 over the first 24 hours of STEMI is associated with death and heart failure. The acute rise of PAI-1 is also a strong independent predictor of death at 30 days.
Collet et al. (2003) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=153). Acute release of PAI-1 and vWF was evaluated on Death at 30 days (p=0.0001). The acute release of PAI-1 over the first 24 hours of STEMI was significantly higher in patients who died at 30 days compared to survivors (46.9 vs -0.6 ng/mL, P=0.0001).