Reduced plasma fibrinolytic capacity as a potential risk factor for a first myocardial infarction in young men

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Abstract
Summary: Studies on the relationship between fibrinolysis and arterial thrombosis have been conflicting. Previously, we demonstrated that hypofibrinolysis, as measured by a plasma‐based assay, increased the risk of venous thrombosis. The present study investigated increased clot lysis time (CLT) measured with the same assay as a risk factor for myocardial infarction in a case‐control study including 421 men with a first myocardial infarction and 642 controls below 70 years. CLT was strongly associated with body‐mass index, lipid levels, blood pressure and C‐reactive protein. Overall, risk of myocardial infarction was 1·4‐fold (95% confidence interval (CI) 1·0–1·9) increased for CLT in the fourth quartile (longest CLT) compared with the first quartile. After adjusting for cardiovascular risk factors this risk disappeared (OR 1·0, 95%CI 0·6–1·5). In men aged <50 years the association was pronounced (OR 3·2, 95%CI 1·5–6·7). After adjustment for cardiovascular risk factors the risk was nearly twofold increased (OR 1·8, 95%CI 0·7–4·8). In men aged ≥50 years, no clear association between CLT and risk of myocardial infarction was found. Our study suggests that hypofibrinolysis increases the risk of a first myocardial infarction in young men, although the causality of this association remains to be determined.

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