Prior to administration of thrombolytic therapy, venous blood was collected from 110 patients presenting with acute ST segment elevation myocardial infarction and plasma assayed for tissue plasminogen activator (t-PA) antigen and activity, plasminogen activator inhibitor type-1 antigen (PAI-1), TAFI antigen and activity, C-reactive protein (CRP) and sCD40L concentrations. Reperfusion was determined using continuous ST segment monitoring.
Reperfusion occurred in 77 (70 % ) patients with a mean treatment to reperfusion time of 83 ± 46 min. Peak creatine kinase was significantly lower in patients who reperfused (1578 ± 1199 versus 2200 ± 1744 U/L; P < 0.05) and correlated with time to reperfusion (r = 0.44 [95 % CI: 0.23 – 0.61], P = 0.0001). There was a modest correlation between plasma TAFI antigen and activity (r = 0.3 [95 % CI: 0.04 – 0.53]; P < 0.05). There were no significant associations between coronary reperfusion and plasma concentrations of t-PA, PAI-1, TAFI, CRP or sCD40L.
Systemic plasma TAFI, sCD40L and CRP concentrations do not predict reperfusion in patients receiving thrombolytic therapy for acute ST elevation myocardial infarction.