ABSTRACT
In blood, the most important determinants of the fibrinolytic system are tissue-type plasminogen activators (t-PA) and plasrninogen activator inhibitor type 1 (PAI-1). Elevated PAI-1 levels have been demonstrated in patients with diseases mainly associated with arterial thrombosis, e.g., coronary artery disease or stroke. Using the increase or decrease in PAI-1 plasma levels as a predictive value for the development of restenosis, a significant association between decrease in PAI-1 and lack of development of restenosis after coronary balloon angioplasty (PTCA) was found. After balloon angioplasty of arterial vessels acute and chronic changes in PAI-1 levels can be distinguished: a temporary early increase of PAI-1 has been demonstrated several hours after balloon angioplasty of the iliac artery in a rabbit restenosis model. PAI-1 levels can be increased in the early phase after PTCA due to acute-phase mechanisms leading also to an increase in t-PA.
