Circulation, Vol 79, 101-106, Copyright © 1989 by American Heart Association
P Angleton, WL Chandler and G Schmer
Previous studies have shown that overall fibrinolytic activity in blood
follows a diurnal rhythm with a peak in the morning and a trough in the
evening. The purpose of this study was to determine which fibrinolytic
factor(s) was responsible for this diurnal rhythm. Resting and postvenous
occlusion tissue-type plasminogen activator (t-PA) activity, resting t-PA
antigen, and resting plasminogen activator inhibitor 1 (PAI-1) activity
were measured in the morning and evening in 33 healthy men (mean age, 31
years) and in 15 patients (mean age, 57 years) with previous myocardial
infarction or unstable angina. PAI-1 activity and t- PA antigen were
significantly higher (p less than 0.01) in the morning compared with the
evening in controls and patients. In contrast, resting t-PA activity was
significantly lower in the morning (p less than 0.01) in both groups and
was inversely correlated with PAI-1 activity (r = -0.57, p less than
0.0001). Postvenous occlusion t-PA activity and t-PA capacity were not
significantly different between morning and evening in either group.
Because t-PA antigen levels and PAI-1 activity were highest in the morning,
the variation in t-PA activity was probably not due to decreased secretion
of t-PA but instead to changes in the secretion of PAI-1. Our findings
indicate that diurnal variations in PAI-1 activity may reduce fibrinolytic
activity in the morning in healthy individuals and in patients with
coronary artery disease.
ARTICLES
Diurnal variation of tissue-type plasminogen activator and its rapid inhibitor (PAI-1)
Department of Laboratory Medicine, University of Washington, Seattle 98195.
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