Elevated Plasma Plasminogen Activator Inhibitor Type-1 is an Independent Predictor of Coronary Microvascular Dysfunction in Hypertension

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Background Elevated plasma plasminogen activator inhibitor-1(PAI-1) is related to cardiovascular events, but its role in subclinical coronary microvascular dysfunction remains unknown. Thus, in the present study it was investigated whether elevated plasma PAI-1 activity is associated with coronary microvascular dysfunction in hypertensive patients. Methods and Results Thirty patients with untreated essential hypertension and 10 age-matched healthy controls were studied prospectively. Myocardial blood flow(MBF) was measured by using 150-water positron emission tomography. Clinical variables associated with atherosclerosis(low-density lipoprotein-cholesterol, high-density lipoprotein(HDL)-cholesterol, triglyceride, homeostasis model assessment(HOMA-IR), and PAI-1 activity) were assessed to determine their involvement in coronary microvascular dysfunction. Adenosine tripho- sphate(ATP)-induced hyperemic MBF and coronary flow reserve(CFR) were significantly lower in hypertensive patients than in healthy controls(ATP-induced MBF: 2.77±0.82 vs 3.49±0.71ml・g^<-1>・min^<-1>; p<0.02 and CFR: 2.95±1.06 vs 4.25±0.69; p<0.001). By univariate analysis, CFR was positively correlated with HDL-cholesterol(r=0.46, p<0.02), and inversely with HOMA-IR(r=-0.39, p<0.05) and PAI-1 activity(r=-0.61, p<0.001). By multivariate analysis, elevated PAI-1 activity remained a significant independent determinant of diminished CFR. Conclusions Elevated plasma PAI-1 activity was independently associated with coronary microvascular dysfunction, which suggests that plasma PAI-1 activity is an important clue linking hypofibrinolysis to the development of atherosclerosis.
社団法人日本循環器学会の論文
2007-02-20

Elevated Plasma Plasminogen Activator Inhibitor Type-1 is an Independent Predictor of Coronary Microvascular Dysfunction in Hypertension

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