Thromb Haemost 1987; 58(03): 817-821
DOI: 10.1055/s-0038-1645996
Original Article
Schattauer GmbH Stuttgart

Depression of Tissue Plasminogen Activator (t-PA) Activity and Rise of t-PA Inhibition and Acute Phase Reactants in Blood of Patients with Acute Myocardial Infarction (AMI)[]

Jørgen Gram
The Section of Coagulation and Fibrinolysis, Department of Clinical Chemistry and Department of Internal Medicine, Ribe Country Hospital in Esbjerg; the Section for Thrombosis Research, South Jutland University Center, Esbjerg, Denmark
,
Cornelis Kluft
*   The Gaubius Institute TNO, Leiden, The Netherlands
,
Jørgen Jespersen
The Section of Coagulation and Fibrinolysis, Department of Clinical Chemistry and Department of Internal Medicine, Ribe Country Hospital in Esbjerg; the Section for Thrombosis Research, South Jutland University Center, Esbjerg, Denmark
› Author Affiliations
Further Information

Publication History

Received 12 February 1987

Accepted after revision 08 May 1987

Publication Date:
28 June 2018 (online)

Summary

We determined during the acute stage of myocardial infarction selected fibrinolysis variables (tissue-type plasminogen activator, intrinsic plasminogen activators, tissue-type plasminogen activator inhibition, C1-inactivator) and relatedthe observed changes to changes in two acute phase reactants (C-reactive protein, fibrinogen). Acute myocardial injury induce significant increases in blood of tissue-type plasminogen activator inhibition (day one, p <0.05), C-reactive protein (day three, p <0.01), fibrinogen (day six, p <0.01), and C1-inactivator (day eight, p <0.01). Tissue-type plasminogen activator activity measured as C1-inactivator resistant fibrinolytic activity showed a minimum day two after the acute attack (p <0.01), whereas plasminogen activator activities arising from the intrinsic system of fibrinolysis remained constant. The observed changes did not parallel the occurrence of deep vein thrombosis indicated by a positive Tc-plasmin test (41% of the patients).

 
  • References

  • 1 Johansson BG, Kindmark C-O, Trell EY, Wohlheim FA. Sequential changes of plasma proteins after myocardial infarction. Scand J Clin Lab Invest 1972; 29 Suppl (124) 117-126
  • 2 Kushner I, Broder ML, Karp D. Control of the acute phase response. Serum C-ieactive protein kinetics after acute myocardial infarction. J Clin Invest 1978; 61: 235-242
  • 3 Hume R. Fibrinolysis in myocardial infarction. Br Heart J 1958; 20: 15-20
  • 4 Ogston D, Fullerton HW. Plasma fibrinolytic activity following recent myocardial and cerebral infarction. Lancet 1965; 2: 99-101
  • 5 Moschos CB, Lehan PH, Koroxenidis GT, Weisse AB, Oldewurtel HA, Regan TJ. Regional and systemic clotting and fibrinolytic activity after myocardial infarction. Am J Physiol 1969; 216: 308-313
  • 6 Bick RL, Bishop RC, Shanbrom ES. Fibrinolytic activity in acute myocardial infarction. Am J Clin Pathol 1972; 57: 359-363
  • 7 Cepelak V, Cepelakova H. Fibrinolytic activity and prognosis of myocardial infarction. In: Davidson JF, Samama MM, Desnoyes PC. (eds.) Progress in chemical fibrinolysis and thrombolysis. Raven Press; New York: 1975: 197-208
  • 8 Gidron E, Margalit R, Oliven A, Shalitin Y. Effect of myocardial infarction on components of fibrinolytic system. Br Heart J 1977; 39: 19-24
  • 9 Knudsen JB, Gormsen J, Skagen K, Amtorp O. Changes in platelet functions, coagulation and fibrinolysis in uncomplicated cases of acute myocardial infarction. Thromb Haemostas 1979; 42: 1513-1522
  • 10 Gopal R, Saxena KK, Gupta B. et al. Plasma fibrinolytic activity and fibrinogen: their relationship in cardiac injury. J Postgrad Med 1982; 28: 200-205
  • 11 Kluft C, Verheijen JH, Jie A FH, Rijken DC, Preston FE, Sue-Ling HM, Jespersen J, Aasen AO. The postoperative fibrinolytic shutdown: a rapidly reverting acute phase pattern for the fast-acting inhibitor of tissue-type plasminogen activator after trauma. Scand J Clin Lab Invest 1985; 45: 605-610
  • 12 Jespersen J, Gram J, Christensen L, Astrup T. Detection of deep vein thrombosis following myocardial infarction by technetium-99m-plas- min test. Nucl Med Commun 1983; 4: 194-203
  • 13 Jespersen J, Astrup T. A study of the fibrin plate assay of fibrinolytic agents: Optimal conditions, reproducibility and precision. Haemostasis 1983; 13: 301-315
  • 14 Gram J, Jespersen J, Astrup T. A delaying influence of cryoglobulins in the assessment of euglobulin fibrinolytic activity. Thromb Res 1986; 41: 781-789
  • 15 Kluft C. Cl-inactivator-resistant fibrinolytic activity in plasma euglobulin fractions: its relation to vascular activator in blood and its role in euglobulin fibrinolysis. Thromb Res 1978; 13: 135-151
  • 16 Kluft C, Jie A FH, Allen R. Behaviour and quantitation of extrinsic (tissue-type) plasminogen activator in human blood. Thromb Haemostas 1983; 50: 518-523
  • 17 Verheijen JH, Mullart E, Chang G TG, Kluft C, Wijngaards G. A simple, sensitive spectrophotometric assay for extrinsic (tissue-type) plasminogen activator applicable to measurements in plasma. Thromb Haemostas 1982; 48: 266-269
  • 18 Astrup T, Rosa AT. A plasminogen-proactivator system in human blood effective in the absence of Hageman factor. Thromb Res 1974; 4: 609-613
  • 19 Kluft C, Wijngaards G, Jie A FH. Intrinsic plasma fibrinolysis: Involvement of urokinase-related activity in the factor Xll-indepen- dent plasminogen proactivator pathway. J Lab Clin Med 1984; 103: 408-419
  • 20 Verheijen JH, Chang G TG, Kluft C. Evidence for the occurrence of a fast-acting inhibitor for tissue-type plasminogen activator in human plasma. Thromb Haemostas 1984; 51: 392-395
  • 21 Jespersen J, Sidelmann J. A study of the conditions and accuracy of the thrombin time assay of plasma fibrinogen. Acta Haematol 1982; 67: 2-7
  • 22 Kluft C, Jie A FH, Lowe G DO, Blarney SL, Forbes CD. Association between postoperative hyper-response in t-PA inhibition and deep vein thrombosis. Thromb Haemostas 1986; 56: 107
  • 23 Chelladurai M, MacIntyre SS, Kushner I. Estimation of in vivo rates of C-reactive protein synthesis from serum turnover studies in rabbits. Ann NY Acad Sci 1982; 389: 437-438
  • 24 Juhan-Vague I, Aillaud MF, De Cock F. et al. The fast-acting inhibitor of tissue-type plasminogen activator is an acute phase reactant protein. In: Davidson JF, Donati MB, Coccheri S. (eds.) Progress in fibrinolysis. VII. Churchill Livingstone; Edinburgh: 1985: 146-149
  • 25 Aillaud MF, Juhan-Vague I, Alessi MC. et al. Increased PA-inhibitor levels in the post-operative period - no cause-effect relation with increased cortisol. Thromb Haemostas 1985; 54: 466-468
  • 26 Nielsen LS, Andreasen PA, Kristensen P, Grpndahl-Hansen J, Skriver L, Danø K. Mr 54,000 plasminogen activator inhibitor from human fibrosarcoma cells. Fibrinolysis 1986; Suppl (01) 41
  • 27 Gram J, Jespersen J. On the significance of levels of antithrombin-III, a2-macroglobulin, a2-antiplasmin, histidine-rich glycoprotein, and protein C in patients with acute myocardial infarction and deep vein thrombosis. Thromb Haemostas 1985; 54: 503-505
  • 28 Murray TS, Lorimer AR, Cox FC, Lawrie T DV. Leg vein thrombosis following myocardial infarction. Lancet 1970; 2: 792-793