Determinants of Plasminogen Activator Inhibitor-1 Activity in Survivors of Myocardial Infarction

Rosaire P Gray; Vidya Mohamed-Ali; David L H Patterson; John S Yudkin

doi:10.1055/s-0038-1653762

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1995; 73(02): 261-267
DOI: 10.1055/s-0038-1653762

Original Article

Fibrinolysis

Schattauer GmbH Stuttgart

Determinants of Plasminogen Activator Inhibitor-1 Activity in Survivors of Myocardial Infarction

Authors

Rosaire P Gray

The Department of Medicine, University College London Medical School, London, UK
Vidya Mohamed-Ali

The Department of Medicine, University College London Medical School, London, UK
David L H Patterson

¹The Department of Cardiology, Whittington Hospital, London, UK
John S Yudkin

The Department of Medicine, University College London Medical School, London, UK

Abstract

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Summary

A significant relationship has been described between plasminogen activator inhibitor-1 (PAI-1) and plasma insulin concentrations. However, most radioimmunoassays (RIA) substantially overestimate plasma insulin concentrations because of cross reaction with proinsulin-like molecules and it has been proposed that proinsulin-like molecules may be important determinants of PAI-1 activity. We measured fasting plasma immunoreactive insulin by conventional RIA, fasting plasma insulin (EIMA) by specific two site immuno-enzymometric assay, and intact proinsulin and des-31,32-proinsulin by two site immunoradiometric assay (IRMA) in 74 (50 nondiabetic and 24 diabetic) subjects who had survived a myocardial infarction between 6 and 24 months previously. In univariate analysis, PAI-1 activity correlated with serum triglycerides (r_s=0.43; p <0.0001), insulin sensitivity (r_s = -0.30; p = 0.004), and immunoreactive insulin (r_s = 0.45; p <0.0001). However, the relationship between PAI-1 activity and plasma specific insulin (IEMA) was weaker (r_s = 0.24; p = 0.019) than those with intact proinsulin (r_s = 0.53; p <0.0001) and des-31,32-proinsulin (r_s = 0.54; p <0.0001) despite the low concentrations of these proinsulin-like molecules. In multiple regression analysis, only des-31,32-proinsulin (p = 0.001) and serum triglycerides (p = 0.013) were significant determinants of PAI-1 activity. In conclusion, these results suggest that proinsulin-like molecules and serum triglycerides are important determinants of PAI-1 activity in survivors of myocardial infarction.

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References

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