Assesment of plasminogen activator inhibitor-1 levels in patients with peripheral varicose vein insufficiency

Peripheral venous insufficiency is clinical disease which occurs as a result of venous valve insufficiency, venous flow obstruction, vessel wall structural abnormality in either deep or superficial venous system. Primary venous disease is frequently seen in adult patients ranging 10% to 40 % in clinical studies.The most important factor in the pathogenesis of primary varicose vein is genetic predisposition and followed by age, gender, immobility, obesity and urban life style. The clinical manifestation of disease varies from simple formation of telengiectasia to severe varicose dilatations and venous ulcers.In this study we aimed to assess and compare plasma levels of plasminogen activator inhibitor-1 in patients with primary varicose vein and control subjects.Study population consisted of 41 patients with primary venous insufficiency and 37 age and gender-matched healthy subjects comprised the control group. Cardiovascular risk factors and presence of varicocele in male patients were recorded. Routine biochemical and complete blood cell analysis were performed in all patients and control subjects. Plasma levels of pai-1 were measured by PAI-1 Assay Max Human Plasminogen Activator Inhibitor 1 ELISA .kits.There were not statistically significant differences between patients and control subjects in respect to cardiovascular risk factors, body mass index and presence of varicocele. However plasma levels of pai-1 was significantly lower in patients with primary venous insufficiency than that of control subject. Additionally logistic regression analysis (by including all cardiovascular risk factors, body mass index and pai-1 levels) revealed that pai-1 level was significantly and independently associated with the presence of primary varicose vein.Although the decreased levels of pai-1 reflects increased fibrinolytic activity, this decreased activity might play a role in extracellular matrix remodeling by increasing matrix metalloproteinase enzymes. This finding provokes further studies to understand the role of pai-1 and MMP system in the pathogenesis of peripheral varicose vein and dilating vascular disease as well.Key words: Peripheral venous insufficiency , varicose vein, PAI-1