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Thrombotic markers during myocardial infarction.

The authors carried out a study on the behavior of some thrombotic molecular "markers" in a group of patients suffering from myocardial infarction, just after the first symptoms and after two weeks from the event. The series consists of 12 subjects (6 males, 6 females, mean age 52 +/- 7), suffering from acute myocardial infarction; just after the first symptoms and instrumental signs (before the thrombolysis) and after two weeks a venous blood withdrawal was done; on the plasma of each sample the determination of fibrinogen (F) (coagulative method), tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), D-dimer (D-D), fibrinopeptide A (FPA) and betathromboglobulin (BTG) (ELISA methods) was performed. The values of t-PA, FPA and BTG did not show remarkable variations; after two weeks from the myocardial infarction compared to the basal values a significant reduction of PAI-1 (4.6 +/- 0.28 UI/ml vs 5.4 +/- 0.33 UI/ml, p < 0.01), D-D (215 +/- 10 ng/ml, vs 253 +/- 12 ng/ml, p < 0.05) and a significant increase of F (294 +/- 28, vs 218 +/- 16 mg%, p < 0.05) were observed. The authors suggest that a basal reduction of the fibrinolytic activity documented by the enhanced PAI-1, may play a major role, influencing pathogenetically the thrombotic event; the other markers seem to be of lower importance, being only secondarily altered in the first phase and gradually returning to a normal pattern after an adequate elapsed time; a preinfarctual hypofibrinolytic condition, probably enhanced by some triggering factor, actually appears the sole prothrombotic system to be counteracted with adequate diet and drug treatments.