Unstable angina and Q wave myocardial infarction are associated with in traluminal coronary thrombosis, a process to which impaired fibrinolysis may contribute. The authors examined the extrinsic fibrinolytic system, including tissue plasminogen activator antigen, plasminogen activator inhibitor activity and an tigen, and euglobulin clot lysis time before and after venous occlusion in 56 pa tients undergoing coronary angiography for chest pain syndromes and in 16 healthy controls. Fibrinolysis variables were similar (with > 95% confidence) in the patients with thrombus-associated coronary syndromes as compared with those with chest pain syndromes not due to coronary thrombosis. These fibrino lytic variables were also similar to those in patients without coronary artery dis ease and in healthy controls. Their data suggest that defective fibrinolysis is not involved, at least systemically, in the pathogenesis of thrombus-associated coro nary artery syndromes.
Get full access to this article
View all access options for this article.
References
1.
Lie JT: Coronary thrombosis and acute myocardial infarction. In; Pathology of Atherosclerotic Coronary Heart Disease, ed. by Waller BF.Philadelphia: FA Davis Co, 1988, pp 23-39.
2.
DeWood MA, Spores J., Notske R., et al: Prevalence of total coronary artery occlusion during the early hours of transmural myocardial infarction. N Engl J Med303:987-990, 1980.
3.
DeWood MA, Stifter WF, Simpson CS, et al: Coronary arteriographic findings soon after non-Q wave myocardial infarction. N Engl J Med315:417-423, 1986.
4.
Sherman CT, Litvack F., Grundfest W.: Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med315:913-919, 1986.
5.
Bachmann F.: Fibrinolysis. In: Thrombosis and Haemostasis, ed. by Verstraete M, Vermylen J , Lynen HR, et al. Leuven: Leuven University Press, 1987, pp 227-265.
6.
Sprengers ED , Kluft C.: Plasminogen activator inhibitors. Blood69:381-387, 1987.
7.
Parmo JA, Colucci M., Collen D.: Plasminogen activator inhibitor in the blood of patients with coronary artery disease. Br Med291:573-575, 1985.
8.
Olofsson BO, Dahlen G., Nilsson TK: Evidence of increased levels of plasminogen activator inhibitor and tissue plasminogen activator in plasma of patients with angiographically verified coronary artery disease. Eur Heart J10:77-82, 1989.
9.
Frances RB, Kawaniski D., Baruch T., et al: Impaired fibrinolysis in coronary artery disease. Am Heart J115:776-780, 1988.
10.
Aznar J., Estelles A., Tormo G., et al: Plasminigen activator inhibitor activity and other fibrinolytic variables in patients with coronary artery disease. Br Heart J59:535-541, 1988.
11.
Almer LO, Ohlin H.: Elevated levels of the rapid inhibitor of plasminigen activator (t-PAI) in acute myocardial infarction. Thromb Res47:335-339, 1987.
12.
Gram J., Jesperson J., Kluft C., et al: On the usefulness of fibrinolysis variables in the characterization of a risk group for myocardial infarction. Acta Med Scand221:149-153, 1987.
13.
Estelle's A. , Tormo G., Aznar J., et al: Reduced fibrinolytic activity in coronary heart disease in basal conditions and after exercise. Thromb Res40:373-383, 1985.
14.
Hamsten A., Wiman V., Faire U., et al: Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med313:1557-1563, 1985.
15.
Juhan-Vague I., Alessi MC, Joly P., et al: Plasma plasminogen activator inhibitor-1 in angina pectoris. Atherosclerosis9899:362-367, 1989.
16.
Johnson O., Mellbring G., Milsson T.: Defective fibrinolysis in survivors of myocardial infarction. Int J Cardiol6:380-382, 1984.
17.
Mehta J., Mehta P., Lawson D., et al: Plasma tissue plasminogen activator inhibitor levels in coronary artery disease: Correlation with age and serum triglyceride concentrations . J Am Coll Cardiol9:263-268, 1987.
18.
Haire WD, Goldsmith JC, Rasmussen J.: Abnormal fibrinolysis in healthy male cigarette smokers: Role of plasminogen activator inhibitors. Am J Hematol31:36-40, 1989.
19.
Meade TW, Chakrabarti R., Haines AP, et al: Characteristics affecting fibrinolytic activity and plasma fibrinogen concentrations. Br Med J1:153-156, 1979.
20.
Hamsten A., Walldius G., Szamosi A., et al: Plasminogen activator inhibitor in plasma: Risk factor for recurrent myocardial infarction. Lancet2:3-9, 1987.
21.
Hoit BD, Gilpin EA, Henning H., et al: Myocardial infarction in young patients: An analysis by age subsets. Circulation74:712-721, 1986.
22.
CASS Princpal Investigators and their Associates: Coronary artery surgery study (CASS): A randomized trial of coronary artery bypass surgery. Survival data. Circulation68:939-950, 1983.
23.
Sheldon WC, Razari M., Lin YJ: Coronary arteriographic findings in young survivors of acute myocardial including those with normal coronary arteries. In: Myocardial infarction at Young Age, ed. by Roskamm H.New York: Springer-Verlag1981, pp 47-55.
24.
Vanhaecke J. , Plessens J., Willems JL, et al: Coronary arterial lesions in young men who survived a first myocardial infarction: Clinical and electrocardiographic predictors of multivessel disease. Am J Cardiol47:810-814, 1981.
25.
Verheugt Fwa , Cate JW, Sturk A., et al: Tissue plasminogen activator activity and inhibitor in acute myocardial infarction and angiographically normal coronary arteries. Am J Cardiol59:1075-1079, 1987 .
