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Endogenous tissue-type plasminogen activator (tPA) has been hypothesised to be a marker of baseline fibrinolytic capacity. We therefore tested whether tPA antigen is associated with the occurrence of future myocardial infarction (Ml) among apparently healthy individuals. tPA antigen concentrations were measured at baseline in plasma samples from 231 apparently healthy men from the Physicians' Health Study cohort who later developed Ml, and in an equal number of controls matched for age and smoking habit who remained free of reported cardiovascular disease during a follow-up of 60·2 months.

In crude matched-pair analyses, baseline concentrations of tPA antigen were higher in cases than controls (p=0·03) and strongly associated with risk of future Ml. Specifically, the relative risks of developing a first Ml from lowest (referent) to highest quintiles of tPA antigen were 1·00, 1·27, 1·75, 1·88, and 2·81 (p for …