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Heart. 1998 Oct;80(4):334-7. doi: 10.1136/hrt.80.4.334.

von Willebrand factor, tissue plasminogen activator, and dehydroepiandrosterone sulphate predict cardiovascular death in a 10 year follow up of survivors of acute myocardial infarction.

Heart (British Cardiac Society)

J H Jansson, O Johnson, T K Nilsson

Affiliations

  1. Department of Internal Medicine, SkellefteƄ Hospital, Sweden.

PMID: 9875107 PMCID: PMC1728802 DOI: 10.1136/hrt.80.4.334
Free PMC Article

Abstract

BACKGROUND: Haemostasis plays a major part in the process initiating a myocardial infarction. The impact of haemostatic variables on long term prognosis is unknown.

OBJECTIVE: To evaluate von Willebrand factor (vWF), tissue plasminogen activator antigen (t-PA) and its activity before and after venous occlusion, plasminogen activator inhibitor (PAI-1), dehydroepian-drosterone sulphate (DHEAS), and established clinical risk factors as long term predictors for reinfarction and mortality.

PATIENTS: 123 consecutive survivors of myocardial infarction followed up for 10 years.

DESIGN: Study entry took place between 1982 and 1983. Fifty seven patients died (54 of cardiovascular disease) during the mean observation time of 10 years.

RESULTS: Cox's univariate regression analysis showed that cardiovascular mortality was significantly associated with age, hypertension, previous history of angina pectoris, DHEAS, mass concentration of t-PA, and vWF. These associations were significant for vWF and mass concentration of t-PA after adjusting for age and hypertension.

CONCLUSIONS: A low concentration of DHEAS and high levels of the endothelially derived haemostatic variables vWF and mass concentration of t-PA are predictors of cardiovascular mortality in survivors of myocardial infarction. This association is independent of established clinical risk factors for mass concentration of t-PA and vWF.

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