ROLE OF PLASMINOGEN-ACTIVATOR INHIBITOR TYPE-1 IN THE PATHOGENESIS OFCORONARY-ARTERY DISEASES

Patients with ischaemic heart disease have high levels of plasminogen activator inhibitor type 1 (PAI-1). These levels can constitute an ind ependent thrombotic risk factor. In addition, PAI-1 synthesis is great er in the atherosclerotic vessels than in the normal vessels and this can also constitute an atherogenic risk factor. There is a good correl ation between insulinaemia and PAI-1, but it has not been demonstrated that the circulating level of PAI-1 depends exclusively on insulinaem ia. The increased levels of PAI-1 correlate with other coronary risk f actors, especially hypertriglyceridaemia, but high PAI-1 levels are al so found in normolipaemic patients. Vascular synthesis of PAI-1 can be promoted by high levels of circulating lipoprotein a. Finally, an exe rcise programme can increase the fibrinolytic activity of heart diseas e patients towards normal.