Alterations in the Fibrinolytic Cascade Post-transplant: Evidence of a Bimodal Expression Pattern

Overview

Journal J Heart Lung Transplant

Publisher Elsevier

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2007 Apr 24

PMID 17449419

Citations 2

Authors

Raymond L Benza

Matthew A Cavender

Joseph Barchue

Jose A Tallaj

Robert C Bourge

James K Kirklin

Christopher S Coffey

Affiliations

Soon will be listed here.

Abstract

Background: Changes in the fibrinolytic system that occur after cardiac transplantation (CTx) and the factors that influence such changes have been poorly described, yet may be important in determining the varying morphologic features of transplant-related coronary artery disease (TxCAD).

Methods: Baseline demographic as well as serial clinical information and plasma fibrinolytic levels were prospectively recorded pre-CTx and at multiple time-points post-CTx in 110 de novo cardiac transplant recipients.

Results: We noted a biphasic change in fibrinolytic activity over the first year of CTx with an early immediate decline in plasminogen activator inhibitor-1 (PAI-1) activity (p > 0.001) matched with stable PAP (plasmin) activity corresponding to an "enhanced" fibrinolytic state early post-CTx. This was followed by a significant increase at 6 months (p = 0.004) and 1 year (p < 0.001) in PAI-1 activity concomitant with a significant decline in PAP after 3 months (p = 0.005 at 3 months, p < 0.001 at 6 months, p < 0.001 at 1 year) corresponding to an "impaired" fibrinolytic state late post-CTx.

Conclusion: The biphasic nature of the fibrinolytic system observed herein may account for the varying morphologic features of TxCAD.

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