Rebound increase of plasminogen activator inhibitor type I after cessation of thrombolytic treatment for acute myocardial infarction is independent of type of plasminogen activator used

Plasma concentrations of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor type 1 (PAI-1), and D-dimer were investigated in 50 patients treated intravenously for acute myocardial infarction with either streptokinase (n = 23), urokinase (n = 17), or recombinant t-PA (rt-PA, n...

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Published in:Clinical chemistry (Baltimore, Md.) Md.), 1998-02, Vol.44 (2), p.209-214
Main Authors: GENSER, N, LECHLEITNER, P, MAIER, J, DIENSTL, F, ARTNER-DWORZAK, E, PUSCHENDORF, B, MAIR, J
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Creatine Kinase - blood
Female
Fibrin Fibrinogen Degradation Products - analysis
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - drug therapy
Myoglobin - blood
Pharmacology. Drug treatments
Plasminogen Activator Inhibitor 1 - metabolism
Recombinant Proteins - therapeutic use
Streptokinase - therapeutic use
Thrombolytic Therapy
Tissue Plasminogen Activator - blood
Tissue Plasminogen Activator - therapeutic use
Urokinase-Type Plasminogen Activator - therapeutic use
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Summary:Plasma concentrations of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor type 1 (PAI-1), and D-dimer were investigated in 50 patients treated intravenously for acute myocardial infarction with either streptokinase (n = 23), urokinase (n = 17), or recombinant t-PA (rt-PA, n = 10). The fibrinolytic variables were measured by enzyme immunoassay on admission; 1, 2, 4, 6, 8, 12, and 24 h later; and then daily until day 7 after admission. In each subgroup of patients treated with different thrombolytic agents, PAI-1 increased significantly (P < 0.01) approximately 3 h after cessation of thrombolytic therapy. PAI-1 peak concentrations did not differ significantly (P = 0.82) among these three subgroups. t-PA and D-dimer did not differ significantly (P > 0.14) among subgroups except for higher t-PA in the rt-PA group attributable to detection of the therapeutically administered exogenous rt-PA by the t-PA assay. Our findings demonstrate a marked PAI-1 increase after thrombolytic therapy for acute myocardial infarction, which seems to be a common, drug-independent antifibrinolytic rebound phenomenon in response to thrombolytic treatment.
ISSN:0009-9147
1530-8561