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Thromb Haemost 1995; 73(02): 261-267
DOI: 10.1055/s-0038-1653762
Original Article
Fibrinolysis
Schattauer GmbH Stuttgart

Determinants of Plasminogen Activator Inhibitor-1 Activity in Survivors of Myocardial Infarction

Rosaire P Gray
The Department of Medicine, University College London Medical School, London, UK
,
Vidya Mohamed-Ali
The Department of Medicine, University College London Medical School, London, UK
,
David L H Patterson
1   The Department of Cardiology, Whittington Hospital, London, UK
,
John S Yudkin
The Department of Medicine, University College London Medical School, London, UK
› Author Affiliations
Further Information

Publication History

Received 19 April 1994

Accepted after resubmission 20 October 1994

Publication Date:
26 July 2018 (online)

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Summary

A significant relationship has been described between plasminogen activator inhibitor-1 (PAI-1) and plasma insulin concentrations. However, most radioimmunoassays (RIA) substantially overestimate plasma insulin concentrations because of cross reaction with proinsulin-like molecules and it has been proposed that proinsulin-like molecules may be important determinants of PAI-1 activity. We measured fasting plasma immunoreactive insulin by conventional RIA, fasting plasma insulin (EIMA) by specific two site immuno-enzymometric assay, and intact proinsulin and des-31,32-proinsulin by two site immunoradiometric assay (IRMA) in 74 (50 nondiabetic and 24 diabetic) subjects who had survived a myocardial infarction between 6 and 24 months previously. In univariate analysis, PAI-1 activity correlated with serum triglycerides (rs=0.43; p <0.0001), insulin sensitivity (rs = -0.30; p = 0.004), and immunoreactive insulin (rs = 0.45; p <0.0001). However, the relationship between PAI-1 activity and plasma specific insulin (IEMA) was weaker (rs = 0.24; p = 0.019) than those with intact proinsulin (rs = 0.53; p <0.0001) and des-31,32-proinsulin (rs = 0.54; p <0.0001) despite the low concentrations of these proinsulin-like molecules. In multiple regression analysis, only des-31,32-proinsulin (p = 0.001) and serum triglycerides (p = 0.013) were significant determinants of PAI-1 activity. In conclusion, these results suggest that proinsulin-like molecules and serum triglycerides are important determinants of PAI-1 activity in survivors of myocardial infarction.

 

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