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Increase in plasma plasminogen activators inhibitor type 1 concentration after fibrinolytic treatment in patients with acute myocardial infarction is associated with 4G/5G polymorphism of PAI‐1 gene
Author(s) -
MLYNARSKA A.,
WASZYROWSKI T.,
KASPRZAK J. D.
Publication year - 2006
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2006.01990.x
Subject(s) - myocardial infarction , medicine , cardiology , plasminogen activator , plasminogen activator inhibitor 1 , polymorphism (computer science) , pharmacology , gene , chemistry , genotype , biochemistry
Summary. Background: Preliminary data suggest that plasma concentration of plasminogen activators inhibitor type 1 (PAI‐1) is genetically determined and may be related to differential regulation of plasma PAI‐1 concentration at baseline and after stimulation. Aim: This study aimed to evaluate whether increase in the plasma PAI‐1 antigen concentration or activity after fibrinolytic therapy in patients with acute myocardial infarction is associated with the −675 4G/5G genetic polymorphism in the promoter region of PAI‐1 gene. Results & Conclusions: Our study revealed that a rebound effect is observed in PAI‐1 activity (ActPAI‐1) and PAI‐1 antigen (AgPAI‐1) concentration after standard streptokinase treatment with maximal values of 3 h ( t 3 ) after the completion of streptokinase infusion. Both ActPAI‐1 and AgPAI‐1 were significantly higher at t 3 compared to the levels before fibrinolytic treatment: 37.3 (20.0–67.7) vs. 10.0 (3.6–26.0) IU L −1 ; P = 0.00001 and 29.9 (15.6–42.3) vs. 20.9 (13.0–30.2) ng mL −1 ; P = 0.001, respectively. The stratification of the patients by genotype revealed that carriers of the 4G allele had higher concentrations of PAI‐1 antigen 3 h after streptokinase infusion: 30.9 vs. 13.8 ng mL −1 ; P = 0.019. No significant association between PAI‐1 activity and genotype was found. In conclusion, the rebound effect in serum PAI‐1 concentration observed after streptokinase treatment may be related to the 4G/5G polymorphism in the PAI‐1 gene promoter.