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.
© 2024. The Author(s).