Tissue plasminogen activator antigen predicts medium-term left ventricular end-systolic volume after acute myocardial infarction

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
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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