RT Journal Article SR Electronic T1 PAI-uPA system in patients with obstructive sleep apnea syndrome (OSAS) in CPAP treatment JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 3288 VO 40 IS Suppl 56 A1 Elena Angelici A1 Alessia Steffanina A1 Caterina Antonaglia A1 Giovanni Alessandrini A1 Michela Mordenti A1 Paolo Palange A1 Rita Canipari YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/3288.abstract AB Background. Prothrombotic state in OSAS play a role for cardiovascular risk. Plasminogen activator inhibitor (PAI) is one of the primary regulators of the fibrinolytic system. We evaluated plasma levels of PAI, uPA and uPA/PAI and their correlation with Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI) and percentage of time with SpO2<90% (T<90%) before and after 1 month with CPAP. Methods. Thirty-nine patients (age 57±1.54; BMI 34.5±1.07) with OSAS (AHI 28.4±3.16; ODI 35.7±3.4; T<90% 23.1±3.3) 20 smokers (S) and 19 no smokers (NS), and 16 age matched healthy control subjects were studied. Before and after 1 month with CPAP, uPA and PAI were measured in serum by ELISA. Results. At baseline, PAI levels were higher in OSAS compared to controls (95.36±3.99 and 83.96±6.06 ng/ml, respectively). PAI levels were similar in S and NS subjects and were inversely related to AHI, BMI, ODI and T<90% in OSAS. uPA was higher in S compared to NS subjects; moreover, it was slightly higher in the controls compared to the OSAS (S 0.233±0.03, NS 0.221±0.028; S 0.206±0.01, NS 0.182±0.02 ng/ml, respectively). In OSAS uPA levels were inversed related to AHI, BMI, ODI and T<90%. uPA/PAI ratio was higher in controls compared to OSAS. PAI levels after CPAP slightly decreased, while uPA levels slightly increased. We observed an increase in uPA/PAI ratio from 1.90±0.04 and 2.56±0.55 to 2.14±0.32 and 3.1±0.79, in S and NS patients respectively. Conclusions. Our preliminary data are compatible with an impairment of fibrinolytic activity in OSAS. The increase of uPA/PAI ratio after CPAP suggests a role of the PA system in the reduction of cardiovascular risk through the decrease of the prothrombotic state.