Document Detail

Tissue plasminogen activator antigen predicts medium-term left ventricular end-systolic volume after acute myocardial infarction.
MedLine Citation:
PMID:  19662337     Owner:  NLM     Status:  MEDLINE    
Von Willebrand factor (VWF) and tissue plasminogen activator (t-PA) predict adverse cardiovascular outcome following acute myocardial infarction (AMI) and are weakly associated with pre-discharge left ventricular ejection fraction (LVEF). We examined the relationships between VWF, t-PA antigen, matrix metalloproteinase (MMP)-2,-3, and -9, and B-type natriuretic peptide (BNP), and their predictive effect on serial change in LV volumes in a cohort of patients admitted with AMI. Plasma VWF, t-PA antigen, MMP-2,-3,-9, and BNP were measured at a mean 46 h after AMI in 100 patients (mean age 58.9 +/- 12 years, 77% male) with depressed LVEF. Cardiac magnetic resonance (CMR) imaging was then performed. Biomarker measurement and CMR were repeated at 12 and 24 weeks. Plasma concentrations of VWF, BNP and MMP-9 were elevated while t-PA antigen concentration was at the upper limits of normal; over 24 weeks VWF, t-PA antigen, MMP-9 and BNP decreased significantly. Baseline VWF correlated with BNP (r = 0.35, P < 0.001) and MMP-3 (r = 0.24, P = 0.019) as did t-PA antigen (r = 0.27, P = 0.007 for BNP; r = 0.40, P < 0.001 for MMP-3). t-PA antigen, VWF, MMP-3 and BNP were univariate predictors of LV end-systolic volume at 24 weeks; tPA antigen and BNP remained significant independent predictors on multivariate analysis. t-PA antigen and VWF are related to medium-term LV volumes after AMI, and to MMP-3. This novel link between the coagulation-fibrinolysis system and matrix turnover merits further study in understanding the pathophysiology of adverse ventricular remodeling after AMI.
Robin A P Weir; Sean Balmain; Tracey Steedman; Leong L Ng; Iain B Squire; Anne Rumley; Henry J Dargie; Gordon D O Lowe
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  29     ISSN:  1573-742X     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-08-13     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  421-8     Citation Subset:  IM    
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MeSH Terms
Biological Markers / blood
Double-Blind Method
Matrix Metalloproteinases / blood
Middle Aged
Mineralocorticoid Receptor Antagonists / administration & dosage
Myocardial Infarction / blood*,  drug therapy,  physiopathology
Natriuretic Peptide, Brain / blood
Predictive Value of Tests
Spironolactone / administration & dosage,  analogs & derivatives
Stroke Volume*
Tissue Plasminogen Activator / blood*
Ventricular Remodeling*
von Willebrand Factor / analysis
Reg. No./Substance:
0/Biological Markers; 0/Mineralocorticoid Receptor Antagonists; 0/von Willebrand Factor; 114471-18-0/Natriuretic Peptide, Brain; 27O7W4T232/Spironolactone; 6995V82D0B/eplerenone; EC Plasminogen Activator; EC 3.4.24.-/Matrix Metalloproteinases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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