Document Detail

Mild hyperhomocysteinemia is associated with a decreased fibrinolytic activity in patients after ST-elevation myocardial infarction.
MedLine Citation:
PMID:  16616324     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Elevated homocysteine (Hcy) levels have been associated with increased risk for cardiovascular disease and it has been shown that hyperhomocysteinemia is associated with increased levels of t-PA antigen in individuals without evidence for coronary artery disease (CAD). The aim of this study was to examine if Hcy plasma levels are associated with plasma levels of fibrinolytic factors in patients with CAD and a history of acute myocardial infarction. METHODS: We measured in 56 patients with CAD, 1 month after their first ST-elevation myocardial infarction, plasma levels of Hcy, the fibrinolytic parameters tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-type-1 (PAI-1), and t-PA-PAI-1 complexes. RESULTS: Hcy plasma levels inversely correlated with t-PA activity (r=-0.303, p<0.05). Patients with mild hyperhomocysteinemia (Hcy>15 micromol/L, n=8) showed significantly lower plasma levels of t-PA activity (p<0.05). Regression analysis revealed that out of cardiovascular risk factors and medical treatment only Hcy was significantly associated with t-PA activity. CONCLUSIONS: Patients with CAD after a first myocardial infarction and hyperhomocysteinemia show a reduced t-PA activity independently from cardiovascular risk factors and medical treatment. Homocysteine lowering therapies may increase fibrinolytic activity and thereby may help to avoid atherothrombotic events in patients with CAD after a first myocardial infarction.
Walter Stefan Speidl; Mariam Nikfardjam; Alexander Niessner; Andrea Zeiner; Nelli Jordanova; Gerlinde Zorn; Gerald Maurer; Wolfgang Schreiber; Johann Wojta; Kurt Huber
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-04-17
Journal Detail:
Title:  Thrombosis research     Volume:  119     ISSN:  0049-3848     ISO Abbreviation:  Thromb. Res.     Publication Date:  2007  
Date Detail:
Created Date:  2006-12-22     Completed Date:  2007-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Department of Internal Medicine II, Medical University of Vienna and the Ludwig Boltzman Foundation for Cardiovascular Research, Austria.
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MeSH Terms
Coronary Artery Disease / blood
Homocysteine / blood
Hyperhomocysteinemia / blood*,  etiology
Middle Aged
Myocardial Infarction / blood*,  complications
Risk Factors
Tissue Plasminogen Activator / blood*
Reg. No./Substance:
454-28-4/Homocysteine; EC Plasminogen Activator

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