A Selective Depression of Tissue Plasminogen Activator (t-PA) Activity in Euglobulins Characterises a Risk Group Among Survivors of Acute Myocardial Infarction^[*]

Summary

Among 29 patients recovering from a first-time acute myocardial infarction (AMI) 9 patients suffered reinfarction during a four year follow-up period. The 9 reinfarction patients were found to belong to a subgroup of 17 patients with a selective depression to near zero of euglobulin t-PA activity. None of the group of 12 patients with marked t-PA activity suffered a relapse. Euglobulin fibrinolytic activity as usually assayed did not distinguish between groups with or without relapse.

Keywords

Fibrinolysis - Acute myocardial infarction - Tissue type plasminogen activator - Intrinsic plasminogen activators - C₁-inactivator - Euglobulins

* Undertaken within the framework of the Concerted Action “Thrombosis and Disabilities” (ECAT) of the Commission of the European Communities.

• References

• 1 De Busk RF, Blomqvist CG, Kouchoukos NT. et al Identification and treatment of low-risk patients after acute myocardial infarction and coronary-artery bypass graft surgery. N Engl J Med 1986; 314: 161-166
• 2 Hume R. Fibrinolysis in myocardial infarction. Br Heart J 1958; 20: 15-20
• 3 Merskey C, Gordon H, Lackner H. et al Blood coagulation and fibrinolysis in relation to coronary heart disease. A comparative study of normal white men, white men with overt coronary heart disease, and normal Bantu men. Br Med J 1960; 1: 219-227
• 4 Naimi S, Goldstein R, Proger S. Studies of coagulation and fibrinolysis of the arterial and venous blood in normal subjects and patients with atherosclerosis. Circulation 1963; 27: 904-918
• 5 Ogston D, Fullerton HW. Plasma fibrinolytic activity following recent myocardial and cerebral infarction. Lancet 1965; 2: 99-101
• 6 Chakrabarti R, Hocking ED, Feamley GR, Mann RD, Attwell TN, Jackson D. Fibrinolytic activity and coronary artery disease. Lancet 1968; 1: 987-990
• 7 Gidron E, Margalit R, Oliven A, Shalitin Y. Effect of myocardial infarction on components of fibrinolytic system. Br Heart J 1977; 39: 19-24
• 8 Meade TW, North W RS, Chakrabarti R. et al Haemostatic function and cardiovascular death: early results of a prospective study. Lancet 1980; 1: 1050-1053
• 9 Wilhelmsen L, Svärdsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 23: 501-505
• 10 Estelles A, Tormo G, Aznar J, Espana F, Tormo V. Reduced fibrinolytic activity in coronary heart disease in basal conditions and after exercise. Thromb Res 1985; 40: 373-383
• 11 Jespersen J, Knudsen LH, Sidelmann J. The use of evacuated glass tubes for collection of blood samples for fibrinolytic assays. Thromb Res 1982; 25: 173-176
• 12 Jespersen J, Astrup T. A study of the fibrin plate assay of fibrinolytic agents. Optimal conditions, reproducibility and precision. Haemostasis 1983; 13: 301-315
• 13 Gram J, Jespersen J, Astrup T. A delaying influence of cryoglobulins in the assessment of euglobulin fibrinolytic activity. Thromb Res 1986; 41: 781-789
• 14 Kluft C, Jie A FH, Allen RA. Behaviour and quantitation of extrinsic (tissue-type) plasminogen activator in human blood. Thromb Haemost 1983; 50: 518-523
• 15 Verheijen JH, Mullaert E, Chang G TG, Kluft C, Wijngaards G. A simple, sensitive spectrophotometric assay for extrinsic (tissue-type) plasminogen activator applicable to measurements in plasma. Thromb Haemost 1982; 48: 266-269
• 16 Coccheri S, Astrup T. Thromboplastic and fibrinolytic activities of large human vessels. Proc Soc Exp Biol Med 1961; 108: 369-372
• 17 Paramo JA, Colucci M, Collen D, van de Werf F. Plasminogen activator inhibitor in blood of patients with coronary artery disease. Br Med J 1985; 291: 573-574
• 18 Hamsten A, Wiman B, de Faire U, Blombäck M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985; 313: 1557-1563
• 19 Jespersen J. Venous stasis in patients with angina pectoris and myocardial infarction with particular reference to measurements of t-PA activity, antigen, inhibition, and euglobulin clot lysis time. ECAT Inf Bull 1984; 2: 3-7