Impaired Fibrinolytic Activity Is Present in Children with Dyslipidemias

Dyslipidemias are major risk factors for atherosclerosis and cardiovascular disease. Abnormalities of fibrinolytic and coagulation components are considered useful predictors of cardiovascular morbidity and mortality in adults. This study examined whether fibrinolytic and coagulation components are abnormal in children with dyslipidemia. Thirty-six children with asymptomatic dyslipidemia, and 26 control subjects underwent venous occlusion stress testing with collection of preocclusion and postocclusion blood samples. All samples were assayed for tissue plasminogen activator, plasminogen, plasminogen activator inhibitor-1, α2-antiplasmin, α2-macroglobulin, D-dimer, fibrinogen, and von Willebrand factor. Children with dyslipidemia had significantly decreased levels of tissue plasminogen activator in both preocclusion and postocclusion samples compared with control subjects, reflecting decreased fibrinolytic activity. Children with dyslipidemia also had significantly increased levels of plasminogen, α2-macroglobulin, and fibrinogen in preocclusion and postocclusion samples compared with control subjects. In conclusion, decreased fibrinolytic activity is present in asymptomatic children with dyslipidemias, potentially reflecting endothelial dysfunction and increased risk of cardiovascular disease in early adult life. Further studies are required to determine the usefulness of this marker in predicting disease progression or response to therapy.