Elevated plasma levels of plasminogen activator inhibitor-1 are associated with risk of future incident venous thromboembolism.

deep vein thrombosis fibrinolysis obesity plasminogen activator inhibitor 1 pulmonary embolism venous thromboembolism

Journal

Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508

Informations de publication

Date de publication:
07 2022
Historique:
received: 08 11 2021
accepted: 07 03 2022
pubmed: 16 3 2022
medline: 29 6 2022
entrez: 15 3 2022
Statut: ppublish

Résumé

Plasminogen activator inhibitor-1 (PAI-1), the main inhibitor of fibrinolysis, is frequently elevated in obesity and could potentially mediate the risk of venous thromboembolism (VTE) in obese subjects. However, whether PAI-1 is associated with VTE remains uncertain. To investigate the association between plasma PAI-1 levels and risk of future incident VTE and whether PAI-1 could mediate the VTE risk in obesity. A population-based nested case-control study, comprising 383 VTE cases and 782 age- and sex-matched controls, was derived from the Tromsø Study cohort. PAI-1 antigen levels were measured in samples collected at cohort inclusion. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for VTE across PAI-1 tertiles. The VTE risk increased dose-dependently across PAI-1 tertiles (P for trend <.001) in the age- and sex-adjusted model. The OR of VTE for the highest versus lowest tertile was 1.73 (95% CI 1.27-2.35), and risk estimates were only slightly attenuated with additional stepwise adjustment for body mass index (BMI; OR 1.59, 95% CI 1.16-2.17) and C-reactive protein (CRP; OR 1.54, 95% CI 1.13-2.11). Similar results were obtained for provoked/unprovoked events, deep vein thrombosis, and pulmonary embolism. In obese subjects (BMI of ≥30 kg/m Our findings indicate that plasma PAI-1 is associated with increased risk of future incident VTE and has the potential to partially mediate the VTE risk in obesity.

Sections du résumé

BACKGROUND
Plasminogen activator inhibitor-1 (PAI-1), the main inhibitor of fibrinolysis, is frequently elevated in obesity and could potentially mediate the risk of venous thromboembolism (VTE) in obese subjects. However, whether PAI-1 is associated with VTE remains uncertain.
OBJECTIVE
To investigate the association between plasma PAI-1 levels and risk of future incident VTE and whether PAI-1 could mediate the VTE risk in obesity.
METHODS
A population-based nested case-control study, comprising 383 VTE cases and 782 age- and sex-matched controls, was derived from the Tromsø Study cohort. PAI-1 antigen levels were measured in samples collected at cohort inclusion. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for VTE across PAI-1 tertiles.
RESULTS
The VTE risk increased dose-dependently across PAI-1 tertiles (P for trend <.001) in the age- and sex-adjusted model. The OR of VTE for the highest versus lowest tertile was 1.73 (95% CI 1.27-2.35), and risk estimates were only slightly attenuated with additional stepwise adjustment for body mass index (BMI; OR 1.59, 95% CI 1.16-2.17) and C-reactive protein (CRP; OR 1.54, 95% CI 1.13-2.11). Similar results were obtained for provoked/unprovoked events, deep vein thrombosis, and pulmonary embolism. In obese subjects (BMI of ≥30 kg/m
CONCLUSION
Our findings indicate that plasma PAI-1 is associated with increased risk of future incident VTE and has the potential to partially mediate the VTE risk in obesity.

Identifiants

pubmed: 35289062
doi: 10.1111/jth.15701
pmc: PMC9314992
pii: S1538-7836(22)01910-9
doi:

Substances chimiques

Plasminogen Activator Inhibitor 1 0
C-Reactive Protein 9007-41-4

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1618-1626

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2022 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.

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Auteurs

Tobias Frischmuth (T)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

Kristian Hindberg (K)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.

Pål Aukrust (P)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.

Thor Ueland (T)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.

Sigrid K Braekkan (SK)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

John-Bjarne Hansen (JB)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

Vânia M Morelli (VM)

Thrombosis Research Center, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

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