Plasma Fibrinolytic Activity, Triglyceride, And Acute Coronary Syndrome Related Clinical Research

Objective To investigate the relationship between fibrinolytic activity and serum triglyceride(TG) in patients with acute coronary syndrome(ACS) and explore these clinical correlation between these marker and ACS. Methods The activity of plasminogen activator inhibitor 1(PAI-1) and tissue plasminogen activator(tPA)were simultaneously measured in 88 patients with ACS [54 patients with acute myocardial infarction (AMI),34 patients with unstable angina (UA)],16 people as control subject.Whether the patients with high TG concentration ,the patients with AMI and the patients with UA can be divided into four subgroup:AMI with high TG concentration,AMI with normal TG concentration,UA with high TG concentration,UA with normal TG concentration. Meanwhile of 88 patients with ACS ,the concentration of TG ,total cholesterol(TC) , low density lipoprotein(LDL) and high density lipoprotein(HDL) were determined .The correlation between TC,TG ,LDL,HDL and PAI-1 activity were analysed .To study the correlation of fibrinolytic activity to the area and extent of coronary artery culprit lesion ,the patients undergoing coronary angiograohy were emphatically analyzed.The cardio-vascular events were observed in patients with ACS in earlier 6 weeks. Results (1)The strong relationship between PAI-1 and area and extent of acute coronary syndrome was found (1.0109±0.1502VS 0.8690±0.1063 &1.0622±0.1758 VS0.8663±0.0713 P<0.001)(2) PAI-1 activity in patients with ACS were higher than those of the control group(P<0.001),but tPA activity were lower than those of the control group.In particular the fibrinolytic activity of the high TG concentration in the patients ACS were highly lower than the patients with normal TG concentration (P<0.001). (3)TG positively correlated with PAI-1 activity (r=0.442 P<0.001)negatively correlated with tPA activity(r=-0.43 P<0.001);among TC,TG ,LDL and HDL,PAI-1 Activity only positively correlated with TG..(4)Patients with event had remarkably higher PAI-1 activity than those with uneventful course(P<0.001).Patients with event had remarkably lower tPA activity than those with uneventful course(P=0.003).In particular,the ratio of early cardio-vascular event in patients with high PAI-1 activity and TG concentration was higher than that of patients in other groups (χ~2=14.695 P<0.001) Conclution By impairing fibrinolytic activity ,TG may play an important role in the pathogenesis of ACS. Elevated PAI-1 activity can predict the area and extent of coronary artery culprit lesion.Higher plasma PAI-1 with higher TG concen-tration can indicate an u xpected outcome of the patients with acute coronary syndrom.