Valproic acid treatment decreased plasma PAI-1 antigen levels and reduced the exhaustion of cumulative tissue plasminogen activator release during repeated stimulation in post-myocardial infarction men.
Does valproic acid improve endogenous tissue plasminogen activator release capacity and reduce PAI-1 levels in men with prior myocardial infarction?
Histone deacetylase inhibition with valproic acid improves endogenous fibrinolytic capacity by reducing t-PA release exhaustion and lowering PAI-1 levels in patients with prior myocardial infarction.
Absolute Event Rate: 11% vs 18.4%
p-value: p=0.01
UNLABELLED: The expression of the tissue plasminogen activator (t-PA) gene appears to be under epigenetic control and can be affected by histone deacetylation inhibition. The study aimed to test if histone deacetalyase inhibitor treatment lead to increased t-PA release or reduced exhaustion in t-PA release in response to stimulation, as well as change in plasminogen activator inhibitor-1 (PAI-1) in subjects with coronary disease. In this clinical study, 16 post-myocardial infarction subjects, the perfused forearm model was used with isoprenaline provocation during 20 minutes, to stimulate local t-PA release. Each subject was measured twice on the same day (repeated stimuli sequences) as well as on two different occasions, without treatment and after four weeks of treatment with valproic acid (500 mg, twice daily). Net forearm release for t-PA in response to isoprenaline at minutes 1.5, 3, 6, 9, 12, 15 and 18 was measured, allowing assessment of cumulative t-PA release. There was a reduction in the exhaustion of cumulative t-PA release during repeated and prolonged stimulation with valproic acid treatment compared to non-treatment. Plasma PAI-1 antigen was decreased following treatment compared to non-treatment (18.4 ± 10.0 vs. 11.0 ± 7.1 nanograms/ml respectively, mean with 95% confidence interval). These findings demonstrate that histone deacetylation inhibition increases the capacity for endogenous t-PA release in subjects with vascular disease. Furthermore, the fibrinolytic balance is favored with suppressed PAI-1 levels. More studies are needed to establish the clinical relevance of these findings. TRIAL REGISTRATION: EU Clinical Trials Register 2012-004950-27.
Svennerholm et al. (Wed,) conducted a other in Post-myocardial infarction (n=16). Valproic acid vs. Non-treatment was evaluated on Plasma plasminogen activator inhibitor-1 (PAI-1) antigen concentration (ng/ml) (p=0.01). Valproic acid treatment decreased plasma PAI-1 antigen levels and reduced the exhaustion of cumulative tissue plasminogen activator release during repeated stimulation in post-myocardial infarction men.