Tissue plasminogen activator and plasminogen activator inhibitor-1 levels in patients with acute myocardial infarction and unstable angina

Objective: to compare levels of tissue plasminogen activator and plasminogen activator inhibitor-1 levels in patients with acute myocardial infarction and unstable angina in order to understand the use of high sensitivity c-reactive protein (hscrp), coagulation and fibrinolysis markers for cardiovascular risk assessment. methods: the cross-sectional case-control study compared circulating concentrations of high sensitivity c reactive protein (hscrp), fibrinogen, tissue-type plasminogen activator (tpa), and plasminogen activator inhibitor-1 (pai-1) between patients of acute myocardial infarction (ami) (n = 67), unstable angina pectoris (ua) (n = 35) and healthy control subjects (n = 39) at the king khalid university hospital, riyadh, saudi arabia, from june 2006 to august 2007. results: the patients had significantly higher hscrp (1.06 ± 0.11 vs 0.52 ± 0.14, p<0.01), fibrinogen (426.21 ± 24.09 vs 329.32 ± 13.93, p<0.05), pai-1 (44.02 ± 6.05 vs19.35 ± 3.94, p<0.01) and tpa (12.31 ± 1.16 vs 9.49 ± 0.86, p<0.05) compared to the controls. fibrinogen (329.32 ± 13.93) and pai-1 (19.35 ± 3.94) were higher in both angina and infarction groups compared to the healthy subjects (p<0.01). between the two categories of patients the difference between fibrinogen (449.60 ± 52.98 vs 419.46 ± 23.42) and pai-1 (52.00 ± 17.34 vs 43.19 ± 6.10) levels were non-significant. also, the difference in tpa levels between the controls and angina patients was nonsignificant (9.49 ± 0.86 vs 9.91 ± 1.24 p>0.05). it was higher in infarction patients (14.79 ± 3.14) compared to angina patients and the controls, (p<0.05). compared to the controls, hscrp levels were significantly higher in both the patient groups (0.52 ± 0.14, 1.05 ± 0.28, 1.40 ± 0.20, p<0.01). moreover, they were significantly higher in infarction patients than those suffering from angina (p<0.05). conclusions: cad patients had a procoagulant state and presented with higher levels of hscrp compared to the healthy individuals. moreover, there were significant differences in coagulation markers and hscrp between angina and infarction patients.