Tissue plasminogen activator and leucocyte elastase as predictors of cardiovascular events in subjects with angina pectoris: Edinburgh Artery Study

Aims To evaluate the relationship between haemostatic and rheological facto rs and cardiovascular outcome in subjects with angina pectoris in the gener al population. Methods and Results Two hundred and seven men and women aged 55-74 had evid ence of angina at baseline. Sixty-seven (32.3%) had a fatal or non-fatal ca rdiovascular event during follow-up. Median levels of tissue plasminogen ac tivator antigen and leucocyte elastase were higher in the event group compa red with the no event group (10.0 ng . ml(-1) vs 7.2 ng . ml(-1); P less th an or equal to 0.001, and 40.3 ng . ml(-1) vs 31.0 ng . ml(-1); P less than or equal to 0.01, respectively). Whole blood viscosity was also significan tly higher in the event group than in the no event group (3.80 mPa.s vs 3.5 3 mPa.s; P less than or equal to 0.05). After adjusting for age and sex, un it increases in both tissue plasminogen activator antigen and leucocyte ela stase levels were significantly associated with an increased risk of a card iovascular event. These associations remained after further adjusting for c ardiovascular risk factors and baseline myocardial infarction. The relative risks were 2.07 (95% CI, 1.30-3.45; P less than or equal to 0.01) for tiss ue plasminogen activator antigen and 1.95 (95% CI, 1.12-3.50; P less than o r equal to 0.05) for leucocyte elastase. Conclusion Disturbed fibrinolysis and activation of leucocytes may be impli cated in the development of thrombotic cardiovascular events in subjects wi th angina pectoris in the general population. (C) 2000 The European Society of Cardiology.