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Thromb Haemost 2002; 87(02): 311-316
DOI: 10.1055/s-0037-1612991
Letters to the Editor
Schattauer GmbH

Improved Fibrinolysis after one Year of Treatment with Enalapril in Men and Women with Uncomplicated Myocardial Infarction

Kurt O. A. Boman
1   Department of Medicine and Genetics, Skellefteå County Hospital, Skellefteå
,
Jan-Håkan Jansson
1   Department of Medicine and Genetics, Skellefteå County Hospital, Skellefteå
,
Katarina A. Nyhlén
1   Department of Medicine and Genetics, Skellefteå County Hospital, Skellefteå
,
Torbjörn K. Nilsson
2   Department of Clinical Chemistry, Örebro University Hospital and Department of Biomedicine, Örebro University, Örebro, Sweden
› Author Affiliations
Further Information

Publication History

Received 10 July 2001

Accepted after revision 15 October 2001

Publication Date:
13 December 2017 (online)

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Summary

Aims

To study long-term effects of enalapril on mass concentrations of tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1), tPA/PAI-1-complex and von Willebrand factor (vWF) in both genders with uncomplicated myocardial infarction.

Methods and results

More than three months after an uncomplicated myocardial infarction 82 survivors (46 males, 36 females) were randomised to enalapril/placebo. PAI-1, tPA, tPA/PAI-1-complex and vWF were measured after two weeks, six and 12 months following randomisation. PAI-1 decreased significantly in both genders in the enalapril-treated group after two weeks, with a maximum decrease at six months (mean reduction: 31% equal to 9.8 µg X L–1, CI: 5.2 to 14.5 µg X L–1, p = 0.0001) and remained significantly lower at 12 months. Mass concentration of tPA decreased significantly (mean reduction; 1.81 µg X L–1, CI: 0.903 to 2.708 µg X L–1, p <0.001) after two weeks treatment in both genders but returned to baseline values at 12 months. The tPA/PAI-1-complex decreased and was significantly lower (mean reduction 0.96 µg X L–1, CI: 0.36 to 1.56 µg X L–1, p = 0.003) in the enalapril group after two weeks and six months (p = 0.037). No decrease of vWF was seen in the enalapril group.

Conclusions

Enalapril treatment up to one year depressed mass concentrations of PAI-1 and transiently tPA and tPA/PAI-1 complex indicating an improvement of the fibrinolytic balance in both genders with uncomplicated myocardial infarction.

Keywords

Fibrinolysis - tissue plasminogen activator - plasminogen activator inhibitor - myocardial infarction - ACE-inhibitor
 

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