Increase of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) in plasma after thrombolytic therapy of patients with myocardial infarction. A randomised,placebo-controlled study |
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Institution: | 1. Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA;2. Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA;3. Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA 92093, USA;4. VA San Diego Healthcare System, San Diego, CA 92161, USA;5. Department of Pathology, UC San Diego, La Jolla, CA 92093, USA |
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Abstract: | Based on recent studies we hypothesised that the marked generation of thrombin in patients who undergo coronary thrombolysis was associated with substantial deviations of endogenous tissue-type plasminogen activator (t-PA) and the plasminogen activator inhibitor type 1 (PAI-1) in plasma.In the present placebo-controlled study we observe in 20 patients treated with recombinant t-PA (rt-PA) a marked increase (p<0.001) of antigen concentrations in plasma of endogenous t-PA and PAI-1 during the first 12h after initiation of treatment. The concentrations of endogenous t-PA and PAI-1 in plasma correlated significantly (p<0.05) with an estimate of generated thrombin in vivo, determined as plasma concentrations of thrombin-antithrombin III complexes. We conclude that the generation of coagulant activity following coronary thrombolysis is associated with an increased synthesis and/or release of endogenous t-PA and PAI-1, which suggests that the procoagulant condition involves an altered functional state of the vascular endothelium. |
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