BASAL PLASMA-CONCENTRATION OF TISSUE-PLASMINOGEN ACTIVATOR (T-PA) ANDTHE ADAPTION TO STRENUOUS EXERCISE IN FAMILIAL HYPERCHOLESTEROLEMIA (FH)

Epidemiological studies have provided evidence that attenuated fibrino lytic activity and increased antigen levels of plasminogen activator a re risk factors for coronary heart disease (CHD). In a comparative stu dy, tissue plasminogen activator (t-PA) antigen and activity concentra tions were examined in plasma from familial hypercholesterolaemia (FH) patients without manifest CHD (n = 14) and in age- and sex-matched no rmolipaemic controls (NLC) at rest and after the same bicycle exercise . The FH patients had higher systolic and diastolic blood pressure tha n their controls. The plasma level of t-PA antigen was higher in FH pa tients than in NLC under basal conditions (7.3 +/- 3.1 ng/ml vs 4.8 +/ - 2.2 ng/ml, P = 0.022), whereas no difference was found in t-PA activ ity. Bicycle exercise induced a marked increase in t-PA antigen (P < 0 .001 for both groups) which did not differ between groups. A more prom inent rise in t-PA activity was observed among the FH patients during the exercise (1.71 +/- 0.99 vs 0.85 +/- 0.89 IU/ml, P = 0.24). Neither the basal level of thrombin-antithrombin III complex (TAT) nor the si gnificant increase (P < 0.001 for both groups) induced by exercise dif fered between groups. A high t-PA antigen level may precede clinical m anifestations of cardiovascular disease in patients with familial hype rcholesterolaemia.