Basal plasma concentration of tissue plasminogen activator (t-PA) and the adaption to strenuous exercise in familial hypercholesterolaemia (FH)

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Abstract
Epidemiological studies have provided evidence that attenuated fibrinolytic activity and increased antigen levels of plasminogen activator are risk factors for coronary heart disease (CHD). In a comparative study, tissue plasminogen activator (t-PA) antigen and activity concentrations were examined in plasma from familial hypercholesterolaemia (FH) patients without manifest CHD (n = 14) and in age- and sex-matched normolipaemic controls (NLC) at rest and after the same bicycle exercise. The FH patients had higher systolic and diastolic blood pressure than their controls. The plasma level of t-PA antigen was higher in FH patients than in NLC under basal conditions (7.3 +/- 3.1 ng/ml vs 4.8 +/- 2.2 ng/ml, P = 0.022), whereas no difference was found in t-PA activity. Bicycle exercise induced a marked increase in t-PA antigen (P < 0.001 for both groups) which did not differ between groups. A more prominent rise in t-PA activity was observed among the FH patients during the exercise (1.71 +/- 0.99 vs 0.85 +/- 0.89 IU/ml, P = 0.24). Neither the basal level of thrombin-antithrombin III complex (TAT) nor the significant increase (P < 0.001 for both groups) induced by exercise differed between groups. A high t-PA antigen level may precede clinical manifestations of cardiovascular disease in patients with familial hypercholesterolaemia.

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