Description
Title: Impaired Fibrinolysis in Coronary Artery Disease as Documented by Angiogram
Abstract: Coronary artery disease may be predisposed to by impaired fibrinolysis (CAD). High concentrations of the plasminogen activator inhibitor-1 (PAI-1) have been linked to hypofibrinolysis in patients with CAD. In recent years, research has focused on thrombin activatable fibrinolysis inhibitor (TAFI), a novel regulator of fibrinolytic activity. It works by preventing the ternary complex of tissue plasminogen activator, fibrin, and plasminogen from forming (t-PA). In the past, CAD reports on TAFI levels have produced ambiguous results. In 123 patients who underwent coronary angiography and had plasma levels of PAI-1 and TAFI antigen measured, we evaluated the correlation between these markers’ levels and the degree of stenosis in three groups: angiographically normal arteries (NAn), mild to moderate atheromatosis (MA), and severe atheromatosis (SA). Patients with severe atheromatosis had higher plasma levels of PAI-1 than those with mild/moderate atheromatosis or healthy individuals (66.60, 40.50, and 34.90 ng/mL, respectively; P 0.001). There was no difference between any of the groups for TAFI. Patients with stenosis above 70% had lower plasma levels of TAFI (5.20 and 4.53 g/mL, respectively; P = 0.04) and higher plasma levels of PAI-1 (37.55 and 66.60 ng/mL, respectively; P 0.001) when they were divided into only two groups based on the clinical cut-off point for intervention (stenosis less than or above 70%). When the number of affected vessels was compared to PAI-1 or TAFI levels, no difference was discovered. Conclusion. One can infer a compromised fibrinolysis in stable CAD from a higher level of PAI-1 antigen, though no association with the number of affected vessels was discovered. Curiously, patients with stenosis greater than 70% showed a decreased plasma level of total TAFI levels. To better understand its relationship to the degree and extent of atheromatosis, additional studies measuring functional TAFI are required.
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Medicine
Sub Category: Hematology
Writer Experience: 20+ Years
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