Plasma tissue plasminogen activator-inhibitor complex levels in acute myocardial infarction patients: an observational study

BMC Cardiovasc Disord. 2024 Dec 20;24(1):722. doi: 10.1186/s12872-024-04406-9.

Abstract

Introduction: The activation of the plasmatic coagulation system is a significant contributor to acute myocardial infarction (AMI). This study aimed to investigate the association between the levels of tissue plasminogen activator-inhibitor complex (t-PAIC), thrombin-antithrombin complex (TAT), plasmin-α2 plasmin-inhibitor complex (PIC), and thrombomodulin (TM) with clinical outcomes in patients with AMI.

Methods: Blood samples were collected from 368 patients presenting with acute myocardial infarction in the emergency department to assess levels of t-PAIC, TAT, PIC, and TM. Patients were subsequently followed up for a period of 6 months.

Results: t-PAIC levels were significantly elevated in AMI patients who died compared to those who survived (P < 0.0001). Specifically, of the 368 patients, 48 died and had higher t-PAIC levels above the determined cut-off value of 15.3 ng/mL, while 320 survived and had levels below this threshold (P < 0.001). Furthermore, among the survivors, t-PAIC levels were greater in the major adverse cardiovascular events (MACE) group than in the non-MACE group throughout the 6-month follow-up. Linear regression analysis indicated that high levels of t-PAIC were linked to mortality following acute myocardial infarction and raised the likelihood of MACE in survivors. The ROC curve study revealed that t-PAIC has predictive value for mortality following AMI, with an AUC of 0.871 (95% CI: 0.833-0.904), sensitivity of 81.25%, and specificity of 88.75%. Analysis of the ROC curve and Kaplan-Meier survival curve demonstrated that t-PAIC was able to forecast MACE in individuals who had experienced an AMI, with an AUC of 0.671 (95% CI: 0.620-0.719) for 6-month MACE occurrences.

Conclusion: Our findings suggest that increased t-PAIC levels are correlated with mortality in patients with AMI and the incidence of MACE within a six-month period in survivors.

Keywords: Acute myocardial infarction; Major adverse cardiovascular events; Tissue plasminogen activator-inhibitor complex.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Antithrombin III*
  • Biomarkers* / blood
  • Female
  • Fibrinolysin
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction* / blood
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / mortality
  • Peptide Hydrolases / blood
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Thrombomodulin* / blood
  • Time Factors
  • Up-Regulation
  • alpha-2-Antiplasmin / analysis

Substances

  • Biomarkers
  • Thrombomodulin
  • Antithrombin III
  • antithrombin III-protease complex
  • Peptide Hydrolases
  • THBD protein, human
  • alpha-2-Antiplasmin
  • plasmin-plasmin inhibitor complex
  • Fibrinolysin