Reduced plasma fibrinolytic capacity as a potential risk factor for a first myocardial infarction in young men

Br J Haematol. 2009 Apr;145(1):121-7. doi: 10.1111/j.1365-2141.2008.07569.x. Epub 2009 Jan 16.

Abstract

Studies on the relationship between fibrinolysis and arterial thrombosis have been conflicting. Previously, we demonstrated that hypofibrinolysis, as measured by a plasma-based assay, increased the risk of venous thrombosis. The present study investigated increased clot lysis time (CLT) measured with the same assay as a risk factor for myocardial infarction in a case-control study including 421 men with a first myocardial infarction and 642 controls below 70 years. CLT was strongly associated with body-mass index, lipid levels, blood pressure and C-reactive protein. Overall, risk of myocardial infarction was 1.4-fold (95% confidence interval (CI) 1.0-1.9) increased for CLT in the fourth quartile (longest CLT) compared with the first quartile. After adjusting for cardiovascular risk factors this risk disappeared (OR 1.0, 95%CI 0.6-1.5). In men aged <50 years the association was pronounced (OR 3.2, 95%CI 1.5-6.7). After adjustment for cardiovascular risk factors the risk was nearly twofold increased (OR 1.8, 95%CI 0.7-4.8). In men aged > or = 50 years, no clear association between CLT and risk of myocardial infarction was found. Our study suggests that hypofibrinolysis increases the risk of a first myocardial infarction in young men, although the causality of this association remains to be determined.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Cholesterol, HDL / blood
  • Fibrinolysis / drug effects
  • Fibrinolysis / physiology*
  • Humans
  • Hypertension / blood
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Odds Ratio
  • Risk Factors
  • Tissue Plasminogen Activator
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Triglycerides
  • C-Reactive Protein
  • Tissue Plasminogen Activator