Improved fibrinolysis after one year of treatment with enalapril in men and women with uncomplicated myocardial infarction.

Abstract

AIMS:

To study long-term effects of enalapril on mass concentrations of tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1), tPA/PAI-1-complex and von Willebrand factor (vWF) in both genders with uncomplicated myocardial infarction.

METHODS AND RESULTS:

More than three months after an uncomplicated myocardial infarction 82 survivors (46 males, 36 females) were randomised to enalapril/placebo. PAI-1, tPA, tPA/PAI-1-complex and vWF were measured after two weeks, six and 12 months following randomisation. PAI-1 decreased significantly in both genders in the enalapril-treated group after two weeks, with a maximum decrease at six months (mean reduction: 31% equal to 9.8 microg x L(-1), CI: 5.2 to 14.5 microg x L(-1), p = 0.0001) and remained significantly lower at 12 months. Mass concentration of tPA decreased significantly (mean reduction: 1.81 microg x L(-1), CI: 0.903 to 2.708 microg x L(-1), p < 0.001) after two weeks treatment in both genders but returned to baseline values at 12 months. The tPA/PAI-1-complex decreased and was significantly lower (mean reduction 0.96 microg x L(-1), CI: 0.36 to 1.56 microg x L(-1), p = 0.003) in the enalapril group after two weeks and six months (p = 0.037). No decrease of vWF was seen in the enalapril group.

CONCLUSIONS:

Enalapril treatment up to one year depressed mass concentrations of PAI-1 and transiently tPA and tPA/PAI-1 complex indicating an improvement of the fibrinolytic balance in both genders with uncomplicated myocardial infarction.

• Authors: Kurt O A Boman, Jan-Håkan Jansson, Katarina A Nyhlén, Torbjörn K Nilsson
• Journal: Thrombosis and haemostasis (Thromb Haemost) Vol. 87 Issue 2 Pg. 311-6 (Feb 2002) ISSN: 0340-6245 [Print] Germany
• PMID: 11859853 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Biomarkers
• Macromolecular Substances
• Plasminogen Activator Inhibitor 1
• von Willebrand Factor
• Enalapril
• Tissue Plasminogen Activator

Topics

• Aged
• Angiotensin-Converting Enzyme Inhibitors (pharmacology, therapeutic use)
• Biomarkers
• Double-Blind Method
• Enalapril (pharmacology, therapeutic use)
• Female
• Fibrinolysis (drug effects)
• Follow-Up Studies
• Humans
• Macromolecular Substances
• Male
• Middle Aged
• Myocardial Infarction (drug therapy, epidemiology)
• Plasminogen Activator Inhibitor 1 (analysis)
• Risk Factors
• Sex Factors
• Tissue Plasminogen Activator (analysis)
• von Willebrand Factor (analysis)