Impaired endogenous fibrinolysis in diabetes mellitus: Mechanisms and therapeutic approaches

In type II diabetes mellitus the activity of the endogenous fibrinolytic sy stem is reduced secondary to increased plasma activity of the plasminogen a ctivator inhibitor type 1 (PAI-1), Because PAI-1 is considered an independe nt risk; factor for cardiovascular disease, increased PAI-1 activity in dia betes mellitus may partly explain the increased susceptibility to both prim ary atherosclerosis and restenosis after angioplasty in this disease. The f actors contributing to increased PAI-1 expression in diabetes mellitus are reviewed as well as possible therapeutic approaches to normalize increased PAI-1 expression.