Relation of tissue-type plasminogen activator and plasminogen activator inhibitor to metabolic variables and atherosclerosis in a family cohort study

Summary Risk prediction of arteriosclerotic vessel disease by hemostatic variables presupposes an association between the disease and hemostatic factors. In a family cohort study the relationship of t-PA antigen, t-PA activity, active PAI antigen and whole PAI antigen to metabolic variables and arteriosclerotic signs has been investigated. 260 members (135 males and 125 females) on indexpatients with hyperuricaemia and / or combined hyperlipidemia were included. t-PA activity was strongly correlated with PAI-1 (active PAI antigen > whole PAI antigen) and showed an inverse relation to t-PA antigen. t-PA antigen was stronger correlated with the active PAI-1 antigen than with whole PAI-1 antigen. An increase of t-PA antigen was associated with a proportional increase of PAI-1 antigen as a cause for the inverse relation between t-PA activity and t-PA antigen. The circulating t-PA activity is influenced predominantly by the active PAI-1 antigen. Although both PAI-1 antigens were positively correlated with t-PA antigen, the active PAI antigen was stronger associated with t-PA antigen. Possibly, a high ratio of whole PAI antigen / active PAI antigen is caused by an increase of latent PAI, the main form of PAI in the platelets. The circulating fibrinolytic activity is better characterised by the active PAI-1 antigen than by the whole PAI-1 antigen. The obtained results indicate to include t-PA and PAI-1 into the metabolic syndrome. The evaluation of the individual results give reason to suppose the existence of a common reaction of the hemostatic risk factors t-PA antigen, active PAI-1 antigen, fibrinogen and von Willebrand factor antigen. A high hemostatic state was predominantly found in patients with arteriosclerotic signs.