The changes of fibrinolytic system and reactive oxygen species production during acute myocardial ischemia

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The change of fibrinolytic system in patients with unstable angina and acute myocardial infarction is examined by measuring plasma tissue plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI) activity. The plasma levels of PAI activity were higher in unstable angina group than in stable exertional angina group and control group. The plasma levels of t-PA antigen were also higher in unstable angina group than in stable exertional angina group and control group. There were no significant differences in PAI activity and t-PA antigen levels between stable exertional angina group and control group. Furthermore, both PAI activity and t-PA antigen levels in unstable angina group decreased to the levels in stable exertional angina group and control group after treatment. Thus, the increased plasma PAI activity in patients with unstable angina indicates that the fibrinolytic system is impaired in these patients.To examine the fibrinolytic capacity in patients with acute … More myocardial infarction (AMI), baseline levels of plasma PAI activity and t-PA antigen were measured in 47 patients with Q wave AMI who underwent emergent coronary angiography 3.0 <plus-minus> 0.2 hours after the symptom onset. They had administration of intracoronary thrombolysis with urokinase if their infarct-related arteries were occluded. They were divided into 3 groups according to the patency of the infarct-related artery before and after thrombolytic therapy : the patent group (13 patients), the recanalized group (23 patients), and the occluded group (11 patients). The mean level of plasma PAI activity was higher in the patients with AMI as a whole than in the control group. The level was lower in the patent group and higher in the recanalized group and the occluded group than in the control group. The level was lower in the occluded group than in the recanalized group and 62% of the patients in the occluded group had the levels within the range of the control group. The mean level of plasma t-PA antigen was higher in the patients with AMI as a whole than in the control group. There was no difference in the level among the 3 AMI groups. Thus, this study indicates that there is a significant relation between the baseline plasma fibrinolytic capacity and the patency of the infarct-related artery before and after the thrombolytic therapWe examined reactive oxygen species production of polymorphonuclear leukocytes (PMLS) in patients with AMI, in thosh with stable exertional angina and in control patients by using chemiluminescence assay of peripheral blood. It was showed that PMLs were activated and the production of reactive oxygen species of PMLs was increased in the patients with AMI. Less