Summary
The habitual level of PAI-1 is influenced by many factors, of which obesity and insulin
resistance are the most important. It is possible to reduce plasma PAI-1 by changes
in life style, e.g. weight reduction and physical activity. Data on potential interactions
between environmental and metabolic variables on one hand, and the 4G/5G-polymorphism
on the other hand, are still scarce. It becomes more and more clear that PAI-1 may
possibly not be a major (causal) factor in cardiovascular disease, but its role in
inflammation deserves further attention. In the presence of the 4G-allele not only
the PAI-1 response was more pronounced, but also the response of other acute-phase
reactants, which implies that the increases of these reactants are secondary to the
increase in PAI-1. A myocardial infarction also provokes an acute phase response.
It can thus be hypothesized that the 4G-allele might exacerbate tissue injury during
the acute phase after a myocardial infarction, and thereby negatively affect the prognosis.
Keywords
PAI-1 - determinants - review