Fibrinolysis and diabetic vascular disease: roles of plasminogen activator inhibitor-1 and thrombin-activatable fibrinolysis inhibitor

被引:6
作者
Aso, Yoshimasa [1 ]
机构
[1] Dokkyo Med Univ, Koshigaya Hosp, Dept Internal Med, Koshigaya, Saitama 343, Japan
来源
FUTURE LIPIDOLOGY | 2006年 / 1卷 / 04期
关键词
atherothrombosis; coagulation; fibrinolysis; plasminogen activator inhibitor-1; thrombinactivatable; fibrinolysis inhibitor; Type; 2; diabetes;
D O I
10.2217/17460875.1.4.429
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Diabetes is a major risk factor for cardiovascular morbidity and mortality, and is associated with poorer outcomes after acute coronary syndromes. Patients with Type 2 diabetes have a two- to fourfold higher risk of cardiovascular disease, compared with nondiabetics. Hypercoagulation and impaired fibrinolysis can lead to excessive fibrin accumulation within vessels, and in patients with Type 2 diabetes they can result in the onset of thrombosis. Impaired fibrinolysis may be induced by elevated plasma concentrations of plasminogen activator inhibitor (PAI)-1 or thrombin-activatable fibrinolysis inhibitor (TAFI), both potent inhibitors of fibrinolysis. Elevated plasma PAI-1 is strongly associated with insulin resistance and obesity, while elevated plasma TAR may be associated with hypercholesterolemia rather than insulin resistance. Therefore, medications that ameliorate impaired fibrinolysis by decreasing PAI-1 and TAR concentrations may reduce an increased risk of cardiovascular disease. This review highlights the way in which PAI-1 and TAR contribute to the impaired fibrinolysis and atherothrombosis that is seen in patients with Type 2 diabetes.
引用
收藏
页码:429 / 440
页数:12
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