Cited by 602Blood Coagulation and Thrombosis MechanismsAcute Myocardial Infarction ResearchBlood properties and coagulation

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High Plasminogen Activator Inhibitor and Tissue Plasminogen Activator Levels in Plasma Precede a First Acute Myocardial Infarction in Both Men and Women: Evidence for the Fibrinolytic System as an Independent Primary Risk Factor

Thögersen, Anna M., Jansson, Jan-Håkan, Boman, Kurt, Nilsson, Torbjörn K., Weinehall, Lars, Huhtasaari, Fritz, Hallmans, Göran·1998·Circulation

DOI 10.1161/01.cir.98.21.2241

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Abstract

Background —In patients with established ischemic heart disease, prospective cohort studies have indicated that plasminogen activator inhibitor (PAI-1), the inhibitor of the fibrinolytic system, may predict cardiovascular events. So far, there have been no primary prospective studies of PAI-1. Methods and Results —The aim of the present study was to test whether plasma levels of PAI-1, tissue-type plasminogen activator (tPA), von Willebrand factor (vWF), and thrombomodulin (TM) could predict the occurrence of a first acute myocardial infarction (AMI) in a population with high prevalence of coronary heart disease by use of a prospective nested case-control design. Mass concentrations of PAI-1 and tPA were significantly higher for the 78 subjects who developed a first AMI compared with the 156 references matched for age, sex, and sampling time; for tPA, this increase was independent of smoking habits, body mass index, hypertension, diabetes, cholesterol, and apolipoprotein A-I. The ratio of quartile 4 to 1 for tPA was 5.9 for a patient to develop a first AMI. The association between tPA and AMI was seen in both men and women. Increased levels of vWF were associated with AMI in a univariate analysis. High levels of TM were associated with AMI in women but not in men. Conclusions —The plasma levels of PAI-1, tPA, and vWF are associated with subsequent development of a first AMI; for PAI-1 and tPA, this relation was found in both men and women. For tPA but not for PAI-1 and vWF, this association is independent of established risk factors.

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Authors: Thögersen, A. M., Jansson, J.-H., Boman, K., Nilsson, T. K., Weinehall, L., Huhtasaari, F., & Hallmans, G.
Affiliations: From the Department of Medicine (A.M.T.), Department of Clinical Chemistry (T.K.N.), and Departments of Nutritional Research and Pathology (G.H.), Umeå University Hospital; Department of Medicine-Geriatric, Skellefteå County Hospital (J.-H.J., K.B.) and Department of Epidemiology and Public Health (L.W.), University of Umeå; and Department of Medicine, Luleå Hospital (F.H.), Sweden.
University Hospital of Umeå (SE)
ORCID: Boman, Kurt
Weinehall, Lars
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1998-11-24
Volume: 98
Issue: 21
Pages: 2241-2247
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.98.21.2241
OpenAlex: W1976057876
Cited by: 602
References: 30
Citations by year: 2026: 3 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 19 · 2021: 10 · 2020: 10 · 2019: 6 · 2018: 14 · 2017: 7 · 2016: 17 · 2015: 12 · 2014: 27 · 2013: 20 · 2012: 19
FWCI: 10.91
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: Umeå Universitet
Topics: Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Hematology › Blood properties and coagulation
Keywords: plasminogen activator inhibitor-1, tissue plasminogen activator, acute myocardial infarction, von Willebrand factor, thrombomodulin, fibrinolysis, coronary artery disease, cardiovascular risk prediction, sex differences, plasma biomarkers
MeSH terms: Adult, Age Factors, Female, Fibrinolysis, Humans, Middle Aged, Myocardial Infarction, Tissue Plasminogen Activator, Predictive Value of Tests, Prospective Studies, Risk Factors, Sex Factors, Sweden, Biomarkers, Plasminogen Inactivators, Incidence, Case-Control Studies, Dehydroepiandrosterone Sulfate

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High Plasminogen Activator Inhibitor and Tissue Plasminogen Activator Levels in Plasma Precede a First Acute Myocardial Infarction in Both Men and Women: Evidence for the Fibrinolytic System as an Independent Primary Risk Factor

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