Streszczenie









POWRÓT DO POPRZEDNIEJ STRONY



Angiographic presentation of infarct related artery depends on plasminogen activator inhibitor type 1 activity during the acute phase of MI.

Joanna Wilczyńska, Elżbieta Kazulak, Grzegorz Horszczaruk, Janusz Kochman, Grzegorz Opolski
SP CSK, Warszawa


Aim: to evaluate a potential relationship of baseline plasminogen activator inhibitor type 1 activity (PAI-1a) and its changes during the first 3 days of acute myocardial infarction (AMI) on patency, degree of stenosis and blood flow in infarct related artery (IRA).

Methods: 33 patients (pts) hospitalized because of ST- segment elevation AMI were enrolled. PAI-1a was measured on admission and every 8 hours during the first 3 days of AMI. Coronary angiography was performed on 7th-14th day. IRA patency, degree of stenosis and blood flow were assessed. Results: study group consisted in 85% of men; mean age 56±10 years. 31 pts (94%) were given streptokinase. Pts were divided into 4 groups based on coronary angiography: with total IRA occlusion - 8pts; tight stenosis (>80%) - 13 pts; significant stenosis (50-79%) - 8 pts; without visible stenosis - 8 pts. The highest baseline PAI-1a (17,3±2,2 U/mL) was found in pts without visible stenosis, significantly higher than in pts with significant, but not tight stenosis (8,3±7; p=0,02) The highest increase of PAI-1a in 1st and 2nd day was found in pts with tight stenosis (respectively: 29,7±9,8 vs 21,7±9,2 and 20,6±11,8 vs 13,6±0,4). No relationship between PAI-1a and TIMI flow was found.

Conclusions: Pts without visible IRA stenosis have the highest baseline PAI-1a. It may be responsible for formation of large occlusive thrombus in that group of pts. Pts with tight IRA stenosis have the highest PAI-1 activity increase. More pronounced coagulation on ruptured plaque. leading to stenosis enlargement and threatening reocclusion, could be present in those pts.







POWRÓT DO POPRZEDNIEJ STRONY

© Copyright by Polskie Towarzystwo Kardiologiczne 2001