Weir, R.A.P., Balmain, S., Steedman, T., Ng, L. L., Squire, I. B., Rumley, A., Dargie, H.J. and Lowe, G.D.O. (2010) Tissue plasminogen activator antigen predicts medium-term left ventricular end-systolic volume after acute myocardial infarction. Journal of Thrombosis and Thrombolysis, 29(4), pp. 421-428. (doi: 10.1007/s11239-009-0383-6)
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Abstract
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 +/- A 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
Item Type: | Articles |
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Keywords: | acute myocardial infarction AGE ANGINA-PECTORIS ARTERY BLOOD BRAIN NATRIURETIC PEPTIDE Cardiac magnetic resonance Cohort CONGESTIVE-HEART-FAILURE DISEASE DYSFUNCTION EJECTION FRACTION ENDOTHELIAL-CELLS haemostasis HEART Imaging INFARCTION INHIBITOR-1 MATRIX METALLOPROTEINASES Measurement MMP-9 Myocardial infarction MYOCARDIAL-INFARCTION outcome PATIENT patients PLASMA predictors RISK Scotland SUDDEN-DEATH SYSTEM Tissue plasminogen activator antigen TISSUE-PLASMINOGEN-ACTIVATOR vascular disease ventricular ejection fraction von Willebrand factor VON-WILLEBRAND-FACTOR |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Dargie, Professor Henry and Lowe, Professor Gordon and Hopkins, Mrs Tracey |
Authors: | Weir, R.A.P., Balmain, S., Steedman, T., Ng, L. L., Squire, I. B., Rumley, A., Dargie, H.J., and Lowe, G.D.O. |
College/School: | College of Medical Veterinary and Life Sciences |
Journal Name: | Journal of Thrombosis and Thrombolysis |
ISSN: | 0929-5305 |
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