Diminished Fibrinolysis in Diabetes Mellitus and its Implication for Diabetic Vascular Disease

Introduction Patients with diabetes mellitus suffer from widespread premature atherosclerosis, especially coronary artery disease (CAD). Conventional risk factors such as smoking, obesity, blood pressure and serum lipids fail to explain fully this excess risk [ 11. Diminished fibrinolysis, attributed to increased concentrations of plasminogen activator inhibitor-1 (PAI-l), may help to explain in part the accelerated atherosclerosis and thrombosis observed in diabetic patients. In this review, we discuss the evidence for diminished fibrinolysis in diabetes, the possible causal factors, PAI-1 gene-environment interactions, the clinical implications and relationship to diabetic vascular complications.

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