Plasma plasminogen activator inhibitor-1 predicts myocardial infarction in HIV-1-infected individuals

Abstract

High levels of PAI-1 were associated with risk of first-time MI in HIV-1-infected individuals independently of cardiovascular risk factors, HIV parameters and antiretroviral therapy. Therefore PAI-1 may be used for risk stratification and prediction of CHD, but further studies are needed.

Primary and Secondary Hemostasis in Patients With Subclinical Hypothyroidism: Effect of Levothyroxine Treatment

“…This association has also been confirmed in a recent meta-analysis (25). Overall, the relevance of our results can be better understood when we consider that the risk of MI increases of about 1% each 1 ng/ml increase in PAI-1 levels (26). In our study population we have found a Ϸ11 ng/ml difference in PAI-1 levels among SH patients and controls, which, according to above reported data, should confer a Ϸ11% increase in the thrombotic risk in this clinical setting.…”

Causal Effect of Plasminogen Activator Inhibitor Type 1 on Coronary Heart Disease

“…The overall heterogeneity across studies is high (I 2 =71.5%, P <0.001; Figure 2A). The association estimate is reduced but remains significant in studies using a multivariable‐adjusted model (OR=1.46; 95% CI: 1.13, 1.88; Figure 2B),11, 12, 13, 14, 16, 17, 18, 19, 20, 21, 22, 23, 31 with a lower overall heterogeneity compared with studies applying only an age‐and sex‐adjusted model (I 2 =55.7%, P =0.008; Figure 2B). In the subgroup meta‐analysis based on different PAI‐1 quantile scales, heterogeneity is observed most strongly in the quartile subgroup in both age‐ and sex‐adjusted model (I 2 =81.6%, P <0.001; Figure 2A) and the multivariable‐adjusted model (I 2 =61.7%, P <0.016; Figure 2B).…”

“…Ten studies that adjusted only for age and sex reported association between PAI‐1 and CHD incidence (Table S1), while 13 studies found the same association following adjustment for multiple covariates (eg, BMI, blood glucose, blood lipids, and blood pressure; Table S1). 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 31 Covariates used in each study that included multivariable‐adjusted models are shown in Table S1. Detailed literature screening procedure is presented in Figure 1.…”

“…The association of elevated plasma PAI‐1 levels with CHD incidence has been reported in longitudinal studies 11, 12, 13, 14, 15, 16, 17, 18, 19. However, this association did not always remain consistent after adjusting for cardiovascular risk factors 11, 12, 13, 14, 16, 17, 18, 19, 20, 21, 22, 23. On the one hand, these inconsistencies could be due to small sample sizes and/or restricted study populations (eg, type 2 diabetes mellitus patients, obese individuals, or HIV patients) 20, 24.…”

“…However, this association did not always remain consistent after adjusting for cardiovascular risk factors 11, 12, 13, 14, 16, 17, 18, 19, 20, 21, 22, 23. On the one hand, these inconsistencies could be due to small sample sizes and/or restricted study populations (eg, type 2 diabetes mellitus patients, obese individuals, or HIV patients) 20, 24. On the other hand, the original observational associations including the link between PAI‐1 and CHD are potentially prone to bias from unmeasured confounders or overadjustment for mediators.…”