PLASMA PLASMINOGEN-ACTIVATOR INHIBITOR-1, TISSUE-PLASMINOGEN ACTIVATOR AND SERUM LIPOPROTEIN(A) AFTER REPERFUSION THERAPY IN ACUTE MYOCARDIAL-INFARCTION - COMPARISON BETWEEN SEQUENTIAL AND DIRECT PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

To determine which reperfusion therapy for acute myocardial infarction (AMI) is advantageous to avoid subsequent thrombotic coronary occlusi on, 8 patients with AMI were studied. Four of them (group S) underwent sequential PTCA following unsuccessful intracoronary thrombolysis and the others (group D) direct PTCA. Serial changes in plasma plasminoge n activator inhibitor-1 (PAI-1), plasma tissue plasminogen activator ( t-PA) antigen and serum lipoprotein(a) levels were compared between th e two groups. In group S, plasma PAI-1 levels showed no significant se rial change after PTCA. However, in group D, plasma PAI-I levels incre ased significantly 4-24 h after PTCA. We suggest that more attention s hould be focused on the prevention of thrombotic coronary closure as w ell as mechanical abrupt occlusion after direct PTCA.