Plasminogen activator inhibitor in plasma: risk factor for recurrent myocardial infarction

Lancet. 1987 Jul 4;2(8549):3-9. doi: 10.1016/s0140-6736(87)93050-9.


Measurements of haemostatic function and metabolic and angiographic indices of risk were included in a prospective cohort study of variables predictive of recurrences within 3 years in 109 unselected men with a first myocardial infarction (MI) before the age of 45. In the course of follow-up, 16 patients had at least one reinfarction (fatal recurrences in 9 and nonfatal in 7) and 1 died suddenly. High plasma concentrations of the fast-acting plasminogen activator inhibitor were independently related to reinfarction along with dyslipoproteinaemia involving VLDL and HDL, poor left ventricular performance, and multiple-vessel coronary artery disease. Besides being independently associated with reinfarction in the present population, high triglyceride levels were possibly connected with a predisposition to thrombosis through a coexisting high level of plasminogen activator inhibitor. The data indicate that reduced fibrinolytic capacity due to increased plasma levels of the plasminogen activator inhibitor predisposes to reinfarction in a complex interplay with atherogenic factors, multiple coronary lesions, and compromised left ventricular function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Fibrinogen / analysis
  • Follow-Up Studies
  • Glycoproteins / blood*
  • Hemostasis
  • Humans
  • Lipoproteins, HDL / blood
  • Lipoproteins, LDL / blood
  • Male
  • Methods
  • Middle Aged
  • Myocardial Infarction / blood*
  • Plasminogen Activators / antagonists & inhibitors*
  • Plasminogen Inactivators*
  • Prospective Studies
  • Recurrence
  • Risk
  • Triglycerides / blood


  • Glycoproteins
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Plasminogen Inactivators
  • Triglycerides
  • Fibrinogen
  • Plasminogen Activators