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Fibrinolytic proteins and progression of coronary artery disease in relation to gemfibrozil therapy

Hamsten, A; Syvanne, M; Silveira, A; Luong, LA; Nieminen, MS; Humphries, S; Frick, MH; (2000) Fibrinolytic proteins and progression of coronary artery disease in relation to gemfibrozil therapy. Thrombosis and Haemostasis , 83 (3) pp. 397-403.

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Impaired fibrinolytic function, mainly due to increased plasma plasminogen activator inhibitor-1 (PAI-1) activity, is common in patients with manifest coronary artery disease (CAD) and a predictor of recurrent cardiovascular events. We investigated the relationships of plasma tissue-type plasminogen activator (tPA) and PAI-1 antigen levels, plasma PAI-1 activity and PAI 4/5-guanosine (4G/5G) genotype to CAD progression in 203 middle-aged men participating in the Lopid Coronary Angiography Trial (LOCAT). A higher tPA antigen concentration, whether baseline or on-trial, was associated with a more severe global angiographic response (p < 0.05), an association mainly accounted for by progression of diffuse lesions in graft-affected segments (change in per-patient means of average diameters of segments haemodynamically related to bypass grafts). Plasma PAI-1 activity and mass concentration and 4G/5G PAI-1 genotype were unrelated to angiographic outcome measurements. tPA and PAI-1 antigen increased significantly in the gemfibrozil group (+11.3% and + 16.4%, respectively, p < 0.001), whereas there was no treatment effect on PAI-1 activity (median change 0.0%). It is concluded that fibrinolytic function does not substantially influence progression of CAD as assessed by angiography in middle-aged men. Furthermore, pronounced long-term lowering of serum triglycerides by gemfibrozil treatment does not significantly affect the plasma PAI-1 activity level but increases the plasma tPA and PAI-1 antigen concentrations

Type: Article
Title: Fibrinolytic proteins and progression of coronary artery disease in relation to gemfibrozil therapy
Additional information: UI - 20206010 LA - eng RN - 0 (Antilipemic Agents) RN - 0 (Plasminogen Activator Inhibitor 1) RN - 25812-30-0 (Gemfibrozil) RN - EC (Tissue Plasminogen Activator) PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial DA - 20000615 IS - 0340-6245 SB - IM CY - GERMANY JC - VQ7
Keywords: Aged, AGENTS, ANTIGEN, Antilipemic Agents, Arteries, artery, As, Association, Blood, Bypass, cardiovascular, clinical, Clinical trial, COMMON, CONTROLLED TRIAL, Coronary Angiography, coronary artery, CORONARY ARTERY DISEASE, Coronary Disease, Diameter, disease, drug effects, drug therapy, Fibrinolysis, function, Gemfibrozil, genetics, Genotype, global, graft, Grafts, INCREASES, INHIBITOR, Lesions, LEVEL, Male, MASS, measurement, MEN, Middle Age, outcome, Patient, patients, plasma, Plasminogen Activator Inhibitor 1, Polymorphism (Genetics), PROGRESSION, PROTEIN, Proteins, RANDOMIZED CONTROLLED TRIAL, Research, response, serum, Support, Non-U.S.Gov't, SWEDEN, therapeutic use, therapy, Tissue, Tissue Plasminogen Activator, treatment, TRIAL, Triglycerides
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: http://discovery.ucl.ac.uk/id/eprint/97234
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