Coagulation
Coagulation laboratory tests
Plasminogen activator antigen-1

Author: Jeremy Parsons, M.D. (see Authors page)

Revised: 17 May 2016, last major update November 2012

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Plasminogen activator antigen-1

Table of Contents
Definition / General | Laboratory
Definition / General
  • Uncommon test; perform if strong evidence of familial bleeding disorder, but normal results for von Willebrand disease or possibly if unexplained premature myocardial infarction
  • May predict severe hepatic veno-occlusive disease after allogeneic bone marrow transplantation (Br J Haematol 2002;118:1087)
  • Not a known risk factor for hypercoagulability (Arch Pathol Lab Med 2002;126:1401), although high levels are associated with arterial thrombosis; low levels are associated with rare familial bleeding disorder
  • Has circadian rhythm with highest values in morning; in one study, mean level was 23 ng/mL at 9 am vs. 10 ng/mL at 4 pm; also is acute phase reactant, so don’t measure immediately following thrombosis; also elevated during pregnancy
Laboratory
  • Collection: collect blood from steadily flowing venipuncture, discard first 3 - 5 mL (if this is the only test) and avoid platelet contamination of plasma (platelets contain PAI1) by separating plasma from cells or storing on ice
  • Reject specimen if antifibrinolytic agent is present in specimen
  • Reference range: 4 - 40 ng/mL for antigen assay, 0 - 12 units/mL for functional assay
  • Functional assay: add patient plasma to known amount of urokinase / tPA, which binds to patient PAI1; residual urokinase is detected by adding plasminogen, which converts it to plasmin, which cleaves a chromogenic substrate; amount of released color is inversely proportional to patient PAI1 (inhibitors of antiplasmin and plasmin are present to prevent their interference)
  • ELISA (antigen) assay: also available