PB0632 - Activity of some protease inhibitors in patients with arterial hypertension of high risk.

Background: it is important to set the role of systems which can provide the protection of additional fibrinolysis in the development of thrombotic complication in patients with arterial hypertension of very high risk.

Aims: With this in mind, we investigated the activity of protease inhibitors (alpha-2-macroglobulin - a-2-M and alpha-1-protease inhibitor - a-1-PI) as universal blockers of fibrinolysis in patients with hypertension and concomitant type 2 diabetes.

Methods: We have studied 270 patients with arterial hypertension with stages II and III, 136 of them with concominant diabetes mellitus type 2. We have measured the activity of α-2-M and α-1-IP, and additionly the enzyme and non-enzyme fibrinolitic activity.

Results: We have set that the difference in a-2-M according to the stage of hypertension was not detected (p> 0,05). In contrast, changes in the activity of α-1-IP were characterized by a differentiated dependence: it was greater in stage II than in stage IIII; ( p < 0,05). The presence of diabetes contributes to additional increase (p < 0,05). The effects of inhibitory proteins on fibrinolysis in patients were similar: inhibition of enzymatic fibrinolysis was observed, as evidenced by negative correlations between them, the effect of α-2-M was more significant (t = -1.85; p = 0.06). The non-enzymatic fibrinolysis was not significantly affected. The interaction with sum of fibrinolytic activity was manifested in different ways: weak negative but significant effect of α-1-IP (p = 0.027), no relationship of α-2-M (p = 0.096). Multiple R was 0.31 (p = 0.001), the coefficient of determination was only 0.096, so the direct inhibitory potential was not significally enough.

Conclusion(s): Decompensation of enzymatic fibrinolysis in patients with hypertension with concomitant diabetes mellitus type 2 is associated with increased coordinated activation of alpha-2-macroglobulin and alpha-1-protease inhibitor, but general influence of these systems on the fibrinolysis was low and need an additional learning.