Increased Fibrin Turnover and High PAI‐1 Activity as Predictors of Ischemic Events in Atherosclerotic Patients
作者:
M. Cortellaro,
E. Cofrancesco,
C. Boschetti,
L. Mussoni,
M. Donati,
M. Cardillo,
M. Catalano,
L. Gabrielli,
B. Lombardi,
G. Specchia,
L. Tavazzi,
E. Tremoli,
E. Pozzoli,
M. Turri,
期刊:
Arteriosclerosis and Thrombosis: A Journal of Vascular Biology
(OVID Available online 1993)
卷期:
Volume 13,
issue 10
页码: 1412-1417
ISSN:1049-8834
年代: 1993
出版商: OVID
关键词: atherothrombosis;ischemic events;fibrinolytic variables;plasminogen activator inhibitor;D-dimer
数据来源: OVID
摘要:
A case-control comparison within the framework of the prospective, multidisciplinary PLAT Study was performed to assess whether altered baseline fibrinolytic variables were associated with an elevated risk of ischemic thrombotic events in patients with documented coronary, cerebral, and/or peripheral atherosclerotic disease. Fibrinogen, D-dimer, tissue plasminogen activator (t-PA) antigen, and fibrinolytic activity before and after venous stasis (A=difference between the two values), t-PA inhibitor, and lipid levels in 60 atherosclerotic patients with a thrombotic event during the first year of follow-up were compared with those in 94 atherosclerotic patients without such events, who were matched for age, sex, and diagnosis at enrollment. Events were associated with a higher release of A t-PA antigen (P=.O47), higher D-dimer (P=.O24), and higher t-PA inhibitor (P=.001) levels. A Fibrinolytic activity was correlated inversely with t-PA inhibitor (p<.01) and triglycerides (J*<.05). D-Dimer was also correlated with systolic blood pressure (p<.01). Atherosclerotic patients at higher risk of thrombotic ischemic events are characterized by increased fibrin turnover and impaired fibrinolytic activity due to high t-PA inhibitor levels. This hemostatic disequilibrium may participate with conventional risk factors such as elevated triglyceride levels and systolic blood pressure in the multifactorial mechanism of ischemic sequelae in patients with preexisting vascular atherothrombotic disease.
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