[Changes induced by venous occlusion in coagulation and fibrinolysis in patients with old myocardial infarction].

The levels of hemostatic and fibrinolytic parameters and of molecular markers in venous blood before and after 10 minutes of venous occlusion were measured to evaluate vascular endothelial function in 36 patients with old myocardial infarction, and also in 20 healthy subjects. T-PA activity in the venous blood after occlusion was significantly lower in the patient group compared with the control group, and was lowest in patients with diabetes mellitus. These results were considered to be attributable to elevated PAI-1 and alpha 2 PI levels in these patients. The mean levels of t-PA antigen and VIII R: Ag in venous blood before occlusion were significantly higher in the patient group, but the mean amount of release was no higher in patients than in controls. The plasmin.alpha 2PI complex levels before venous occlusion seemed to indicate the presence of secondary fibrinolysis accompanying hypercoagulability, and the level was significantly higher in patients with diabetes mellitus. Venous occlusion induced the release of t-PA and VIII R: Ag without causing a significant difference in the mean amount of increase of these substances in patient and control groups. However, the lower level of t-PA activity after venous occlusion together with the higher levels of VIII: C, VIII R: Ag, alpha 2PI, PAI-1, and plasmin.alpha 2PI complex before venous occlusion in the patients, indicated that the patient group was in a hypercoagulable and hypofibrinolytic state. In those with diabetes mellitus, the changes were more significant.