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Interrelationship between coagulant activity and tissue‐type plasminogen activator (t‐PA) system in acute ischaemic heart disease. Possible role of the endothelium
Author(s) -
MUNKVAD S.,
JESPERSEN J.,
GRAM J.,
KLUFT C.
Publication year - 1990
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1990.tb00246.x
Subject(s) - fibrinolysis , medicine , plasminogen activator , fibrinogen , unstable angina , myocardial infarction , coagulation , tissue plasminogen activator , von willebrand factor , protein c , t plasminogen activator , antithrombin , tissue factor , endocrinology , platelet , heparin
. Patients with unstable angina pectoris (UAP; n =20) and acute myocardial infarction (AMI; n =34) were studied in the acute phase of ischaemic heart disease. We found significantly higher levels of thrombin‐antithrombin‐III (TAT) complexes, lower levels of systemic tissue plasminogen activator (t‐PA) activity, and higher levels of plasminogen activator inhibitor (PAI) activity in the AMI patients compared to the UAP patients. In contrast to these specific changes, general acute phase reactants such as C‐reactive protein, fibrinogen and von Willebrand factor did not differ significantly between the two groups. Studies of the relationship between coagulation (TAT‐complexes) and fibrinolysis data revealed a significant positive correlation between plasma antigen concentrations of TAT‐complexes and t‐PA ( P < 0.02), and between TAT‐complexes and PAI‐I ( P < 0.002). These observations indicate a common pathophysiological mechanism underlying the changes in coagulation and fibrinolysis, suggesting that coagulation activity and t‐PA‐related fibrinolysis are interrelated processes in vivo , and probably take place at the level of the endothelial cell.