Human circadian system causes a morning peak in prothrombotic plasminogen activator inhibitor-1 (PAI-1) independent of the sleep/wake cycle

FAJL Scheer, SA Shea - Blood, The Journal of the American …, 2014 - ashpublications.org
Blood, The Journal of the American Society of Hematology, 2014ashpublications.org
Serious adverse cardiovascular events peak in the morning, possibly related to increased
thrombosis in critical vessels. Plasminogen activator inhibitor-1 (PAI-1), which inhibits
fibrinolysis, is a key circulating prothrombotic factor that rises in the morning in humans. We
tested whether this morning peak in PAI-1 is caused by the internal circadian system or by
behaviors that typically occur in the morning, such as altered posture and physical activity.
Twelve healthy adults underwent a 2-week protocol that enabled the distinction of …
Abstract
Serious adverse cardiovascular events peak in the morning, possibly related to increased thrombosis in critical vessels. Plasminogen activator inhibitor-1 (PAI-1), which inhibits fibrinolysis, is a key circulating prothrombotic factor that rises in the morning in humans. We tested whether this morning peak in PAI-1 is caused by the internal circadian system or by behaviors that typically occur in the morning, such as altered posture and physical activity. Twelve healthy adults underwent a 2-week protocol that enabled the distinction of endogenous circadian effects from behavioral and environmental effects. The results demonstrated a robust circadian rhythm in circulating PAI-1 with a peak corresponding to ∼6:30 am. This rhythm in PAI-1 was 8-times larger than changes in PAI-1 induced by standardized behavioral stressors, including head-up tilt and 15-minute cycle exercise. If this large endogenous morning peak in PAI-1 persists in vulnerable individuals, it could help explain the morning peak in adverse cardiovascular events.
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