EFFECT OF PURIFIED EICOSAPENTAENOATE ETHYL-ESTER ON FIBRINOLYTIC CAPACITY IN PATIENTS WITH STABLE CORONARY-ARTERY DISEASE AND LOWER-EXTREMITY ISCHEMIA

Background Lower extremity ischaemia is often complicated by coronary artery disease (CAD), Patients with CAD often have impaired fibrinolyt ic capacity, Plasma plasminogen activator inhibitors (PAI) levels are known to be associated with levels of atherogenic lipids. Purified eic osapentaenoic acid reduces atherogenic lipids levels. Objective To exa mine the effect of purified eicosapentaenoic acid ethyl ester (EPA) on the fibrinolytic capacity in patients with stable CAD and arterioscle rosis obliterans (ASO), Methods Plasma levels of PAI activity and tiss ue-type plasminogen activator (t-PA) antigen were measured. We adminis tered 1800 mg/day EPA for 8 weeks to 25 patients. Results Mean baselin e plasma PAI activity (P < 0.01) and t-PA antigen (P < 0.01) levels we re higher in the patient group than they were in the control group, At the conclusion of EPA administration, significant reductions in PAI a ctivity (P < 0.01), t-PA antigen (P < 0.01) and serum levels of trigly ceride (P < 0.01), total (P < 0.05) and low-density lipoprotein (P < 0 .05) cholesterols were observed. Changes in PAI activity levels caused by EPA administration showed positive linear correlations with those in low-density lipoprotein cholesterol (r = 0.411, P < 0.05) and trigl yceride (r = 0.652, P < 0.01) Conclusion These findings indicate that the fibrinolytic capacity in patients with CAD and ASO is decreased by increased PAI activity, but that EPA may correct this fibrinolytic im pairment by decreasing PAI activity via its inhibitory effect on ather ogenic lipids.