This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ott, I. Articles by Neumann, F.-J. Search for Related Content PubMed PubMed Citation Articles by Ott, I. Articles by Neumann, F.-J. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Heart Attack Related Collections Acute myocardial infarction Coagulation and fibronolysis

(Circulation. 2002;105:279.)
© 2002 American Heart Association, Inc.

Brief Rapid Communications

Proteolysis of Tissue Factor Pathway Inhibitor-1 by Thrombolysis in Acute Myocardial Infarction

Ilka Ott, MD; Valerie Malcouvier; Albert Schömig, MD; Franz-Josef Neumann, MD

From Medizinische Klinik und Deutsches Herzzentrum der Technischen Universität München, Germany.

Correspondence to Dr. I. Ott, Deutsches Herzzentrum, Lazarettstr. 36, 80636 München, Germany. E-mail ott{at}dhm.mhn.de

Background— In acute myocardial infarction (AMI), surface-bound tissue factor pathway inhibitor-1 (TFPI-1) inhibits an increased monocyte procoagulant activity. In addition, TFPI-1 is released from microvascular endothelial cells after treatment with heparin and thereby contributes to its antithrombotic properties.

Methods and Results— We examined 19 patients in a randomized study comparing intravenous fibrinolysis with alteplase (n=9) and revascularization by stent placement with additional abciximab treatment (n=10). We obtained blood samples for analysis of monocytic TFPI-1 surface expression by flow cytometry and plasma TFPI-1 concentrations by immunoassay before and after therapy. We found a significant decrease in surface TFPI-1 on circulating monocytes 24 hours after thrombolysis (P=0.006) that was not observed after stenting. Systemic plasma TFPI-1 concentrations increased immediately after stenting by 71±14% (P=0.008), whereas after thrombolysis, a decrease in TFPI-1 plasma concentrations of 21±11% was observed (P=0.075). In vitro experiments confirmed that plasmin decreased TFPI-1 surface expression dose-dependently.

Conclusions— Activation of the fibrinolytic system by alteplase in AMI decreases surface-associated TFPI-1 on circulating monocytes and plasma TFPI-1. Reduced TFPI-1 may contribute to thrombotic complications after fibrinolysis in AMI.

Key Words: myocardial infarction • thrombolysis • leukocytes

This article has been cited by other articles:

				J. T.B. Crawley and D. A. Lane The Haemostatic Role of Tissue Factor Pathway Inhibitor Arterioscler Thromb Vasc Biol, February 1, 2008; 28(2): 233 - 242. [Abstract] [Full Text] [PDF]

				H. Tang, L. Ivanciu, N. Popescu, G. Peer, E. Hack, C. Lupu, F. B. Taylor Jr, and F. Lupu Sepsis-Induced Coagulation in the Baboon Lung Is Associated with Decreased Tissue Factor Pathway Inhibitor Am. J. Pathol., September 1, 2007; 171(3): 1066 - 1077. [Abstract] [Full Text] [PDF]

				Y. Zhao, S. Zhou, and C.-K. Heng Impact of Serum Amyloid A on Tissue Factor and Tissue Factor Pathway Inhibitor Expression and Activity in Endothelial Cells Arterioscler Thromb Vasc Biol, July 1, 2007; 27(7): 1645 - 1650. [Abstract] [Full Text] [PDF]

				V. Fuster, P. R. Moreno, Z. A. Fayad, R. Corti, and J. J. Badimon Atherothrombosis and High-Risk Plaque: Part I: Evolving Concepts J. Am. Coll. Cardiol., September 20, 2005; 46(6): 937 - 954. [Abstract] [Full Text] [PDF]

				S. A. Mousa, J. Bozarth, and J. S. Barrett Pharmacodynamic Properties of the Low Molecular Weight Heparin, Tinzaparin: Effect of Molecular Weight Distribution on Plasma Tissue Factor Pathway Inhibitor in Healthy Human Subjects J. Clin. Pharmacol., July 1, 2003; 43(7): 727 - 734. [Abstract] [Full Text] [PDF]

				P. Dandona, A. Aljada, A. Chaudhuri, and A. Bandyopadhyay The Potential Influence of Inflammation and Insulin Resistance on the Pathogenesis and Treatment of Atherosclerosis-Related Complications in Type 2 Diabetes J. Clin. Endocrinol. Metab., June 1, 2003; 88(6): 2422 - 2429. [Full Text] [PDF]

				R. S. Barua, J. A. Ambrose, D. C. Saha, and L.-J. Eales-Reynolds Smoking Is Associated With Altered Endothelial-Derived Fibrinolytic and Antithrombotic Factors: An In Vitro Demonstration Circulation, August 20, 2002; 106(8): 905 - 908. [Abstract] [Full Text] [PDF]

				P. K. Shah Reduced Tissue Factor Pathway Inhibitor-1 After Pharmacological Thrombolysis: An Epiphenomenon or Potential Culprit in Rethrombosis? Circulation, January 22, 2002; 105(3): 270 - 271. [Full Text] [PDF]