The fibrinolysis and coagulation systems in ischaemic heart disease. Risk markers and their relation to metabolic dysfunction of the arterial intima

This report reviews the major haemostatic deviations associated with the evolution of ischaemic heart disease (IHD) and also such deviations, which might be of importance for the evolution of the acute ischaemic heart syndrome. It is demonstrated that deviation in the t-PA/PAI-1 system indicate endo...

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Bibliographic Details
Published inDanish medical bulletin Vol. 40; no. 4; pp. 495 - 502
Main Authors Jespersen, J, Munkvad, S, Gram, J B
Format Journal Article
LanguageEnglish
Published Denmark 01.09.1993
Subjects
Blood Coagulation - physiology
Fibrinolysis - physiology
Humans
Myocardial Ischemia - blood
Myocardial Ischemia - epidemiology
Myocardial Ischemia - metabolism
Prognosis
Risk Factors
Tunica Intima - metabolism
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Summary:This report reviews the major haemostatic deviations associated with the evolution of ischaemic heart disease (IHD) and also such deviations, which might be of importance for the evolution of the acute ischaemic heart syndrome. It is demonstrated that deviation in the t-PA/PAI-1 system indicate endothelial cell dysfunction in patients with IHD. Different factors which have the capability to induce such an endothelial cell dysfunction are proposed, i.e. hyperinsulinemia, mediators of chronic disease phase response, and thrombin. Finally, the intimate interrelation between coagulation and fibrinolysis in patients with IHD is discussed. The experimental and clinical studies reviewed provide good evidence that the endothelial cell response of t-PA and PAI-1 is coupled and that there is an intimate interrelation between generation of thrombin and production/release of t-PA and PAI-1 in IHD patients.
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ISSN:0907-8916