Abstract
Recent studies have demonstrated that the rupture of the atherosclerotic plaque with superimposed thrombosis triggers the acute coronary syndrome. In addition to the disruption of plaque, disturbances of the fibrinolytic system may contribute to the occurrence and persistence of coronary thrombosis. The dynamics of fibrinolysis is mainly governed by the released amounts of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PA-1) from vascular endothelial cells. PAI-1, which inhibits the fibrinolytic activity through blocking t-PA effect, has been al-ready proved to be inceased in the acute coronary syndrome. Recently, it was reported that t-PA, C-reactive protein (CRP) and PAI-1 might be the predictors of subsequent cardiovasular events in patients with ischemic heart desease (IHD). However, there are few studies of the association between these risk factors and cardiovascular events in the Japanese population. In this review, we show our recent studies focused on the changes of fibrinolytic factors in the acute coronary syn-drome and the factors predicting the risk of cardiovasular events in patients with IHD and discuss the fibrinolytic system as a risk factor of IHD.
