TETRANECTIN LEVELS IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION AND THEIR ALTERATIONS DURING THROMBOLYTIC TREATMENT

Tetranectin (TN), a new regulator of fibrinolysis, was studied in the plasma of 60 patients with acute myocardial infarction (AMI) and 30 he althy subjects (HS), in relation to D-dimer (DD) and alpha(2)-plasmin inhibitor (alpha(2)-PI), to investigate its possible involvement in th e pathophysiology of AMI. Thirty patients underwent thrombolytic treat ment with fibrin-specific plasminogen activator (rt-PA) (group A); the other 30 patients, according to the exclusion criteria, were conventi onally treated (group B). Twenty of the thrombolysized patients establ ished early recanalization (subgroup A(1)), while 10 failed to respond to thrombolytic treatment (subgroup A(2)) Median (interquartile range ), baseline plasma TN levels were lower in AMI patients compared to HS [8.27 (2.75) mg/L versus 12.1 (0.55) mg/L, P< 10(-6)]. In subgroup A( 1), TN increased at the end of rt-PA infusion and returned to the base line levels 12 h later. A positive association between DD and TN relea se (3 h level minus baseline level) was found (r(s) = 0.48, P = 0.03) in subgroup A(1). No significant alterations of TN levels were observe d during therapy in subgroup A(2) and group B. TN, DD and alpha(2)-PI concentrations in group B remained relatively constant during the stud y period. This study provides evidence of a significant decrease of TN levels in AMI patients compared to healthy subjects and of a remarkab le difference in the evolution of TN levels during thrombolytic treatm ent with rt-PA between recanalized and non-recanalized AMI patients. T hus, an involvement of TN in the formation and dissolution of fibrin c lot in AMI patients is worthy of further investigation.