engleski

Plasminogen activator inhibitor 1 in acute myocardial infarction ; Clinical Medical Sciences - Research Abstract

Introduction: Cardiovascular diseases are the main cause of death in Croatia. Acute myocardial infarction is teh most severe form of coronary artery disease. Contemporary treatment of eligible patients include primary percutaneous coronary intervention (PCI). Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of plasminogen activation. It is secreted by endothelial cells and platelets, and in some circumstances by other cells. By reviewing recent data, no reference on PAI-1 value in prediction of long term outcome for patients with acute myocardial infarction treated with primary percutaneous coronary intervention could be found. Materials and methods: Patients treated with primary PCI for acute STEMI were included in the study, while those with altered immune response due to medical treatment, acute inflammatory illness or malignancy were excluded. PAI-1 activity was determined at arrival and after 24 hours. CPK levels were determined every 6 hours until drop. Outcomes were determined by telephone interview. Results: A total of 87 patients were enrolled in the study with average age of 60 and male predominance (71%). Risk profile was observed as follows: 67% with medical history of hypertension, 15% of diabetes, 53%of smokers and 65% of dyslipidemia. Diagnosis of CAD was already established in 13% of patients, while prior PCI was performed in 8%. Long term usage of aspirin was reported by 15%, beta blockers by 15%, ACE inhibitors by 24% and statins by 7%of patients. On presentation, heart failure was present in 10%, cardiogenic shock 3%, ventricular fibrillation occured in 13% of patients. All patients received aspirin and clopidogerl, while eptifibatide was used in 73% of patients. Most common culprit lesion was in right coronary artery (49%), followed by left anterior descending (39%) and circumflex artery (12%). Initial TIMI flow of 0 was observed in 78%, stents were implanted in 95%, and final TIMI III flow was obtained in 79% of patients. Two patients died during initial hospitalization. Average value of PAI-1 activity on arrival was 3.25 U/mL, a and after 24 hours 4.71 U/mL (an increase of 45%). Data on follow up could not be reported. Discussion: The inclusion period is finished. teh study population resembles one typical of STEMI patients with high incidence of hypertension, smoking and dyslipidemia. Other descriptive characteristics of study population are also as expected. The main study results can not be presented due to incomplete follow up.

plasminogen activator inhibitor-1; acute myocardial infarction; primary percuteneous coronary intervention; long term outcome; no reflow phenomenon

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