Plasminogen activator inhibitor-1 and the calculus of mortality after myocardial infarction.

There are numerous clinical factors that have been identified that are associated with an adverse outcome after acute myocardial infarction (MI). These factors include female gender, the presence of severe left ventricular dysfunction or congestive heart failure, a history of diabetes mellitus, age 70 years, infarct location (anterior versus inferior), and patency of the infarct-related artery. In this issue of Circulation, Collet and colleagues1 describe a previously unrecognized relationship between acute increases in plasma levels of plasminogen activator inhibitor-1 (PAI-1) in patients hospitalized with acute ST-elevation MI and risk of mortality during a 1-month period.