Clinical significance of plasma tissue plasminogen activator and plasminogen activator inhibitor-1 in chronic stable angina

ABSTRACT

BACKGROUND: Impaired fibrinolytic system has been considered to play an important role in the pathogenesis of coronary artery disease, especially associated with thrombus formation. To evaluate the pathogenetic role of fibrinolytic system in coronary artery disease, major determinants of fibrinolytic system, tissue plasminogen activator(t-PA) and palsminogen activator inhibitor-1(PAI-1) levels were measured in control(n=7) and chronic stable angina patients(n=7). METHODS: Blood samplings were done in resting state, venous occlusion and peak exercise. Levels of plasma t-PA antigen and PAI-1 antigen were measured by ELISA method. RESULTS: 1) In resting state, there was no significant difference in plasma level of t-PA(control group : 9.15+/-2.82ng/ml vs, study group ; 9.65+/-3.53ng/ml) and PAI-1(control group ; 20.27+/-9.98ng/ml vs, study group ; 17.43+/-3.53ng/ml) between each group. 2) With venous occlusion test, increment of plasma t-PA level was noted in both groups which was lower in patient group, however, this difference in increment was not statistically significant. 3) Increased plasma t-PA level was noted after exercise in both groups. 4) Plasma level of PAI-1 was not significantly changed after venous occlusion or exercise in both groups. CONCLUSIONS: In patients with chronic stable angina, there was no definite evidence of impaired fibriolytic system although plasma t-PA increased somewhat less after venous occlusion in patients with chronic stable angina than control.