Detection of hypofibrinolysis in stable coronary artery disease using the overall haemostatic potential assay
Detection of hypofibrinolysis in stable coronary artery disease using the overall haemostatic potential assay
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DOI：
10.1016/j.thromres.2013.03.015
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发表时间：
2013-05-01
影响因子：
7.5
通讯作者：
Brieger, David B.
中科院分区：
文献类型：
--
作者：
Reddel, Caroline J.;Curnow, Jennifer L.;Brieger, David B.
简介：患有稳定性冠状动脉疾病（CAD）的患者存在动脉血栓形成导致心肌梗塞的风险。高凝和纤溶低下的整体止血标志物的检测对于风险分层和个体化治疗可能很重要。我们检查了一组稳定 CAD 患者的总体止血潜力 (OHP) 和凝血酶生成。我们还试图研究这些患者中纤溶抑制剂与整体纤溶异常之间的关联。材料和方法：从 56 名根据冠状动脉解剖学定义为症状稳定 CAD 的患者中采集血样。记录了用药情况。使用整体凝血分析 OHP 和凝血酶生成（校准的自动血栓图，CAT）、Multiplate (R) 测量的血小板聚集度以及 ELISA 测量的纤溶酶原激活物抑制剂 1 (PAI-1) 抗原水平对样本进行分析。将结果与健康对照参考组进行比较。结果：与健康对照相比，稳定的 CAD 患者表现出纤维蛋白和凝血酶生成增加以及纤溶受损（总体纤溶潜力、OFP 降低和血栓溶解时间增加）。使用贫血小板血浆没有观察到抗血小板药物或其他药物对这些参数的影响。经过多变量调整后，健康个体的 OFP 与纤维蛋白原显着相关，但在 CAD 患者中，PAI-1 成为重要的决定因素。结论：在稳定的 CAD 中观察到血浆高凝状态，其中凝血酶生成增加和纤溶电位降低均做出了显着贡献。 OHP 测定可以提供一种识别个体患者高凝状态的简单方法。 (C) 2013 Elsevier Ltd. 保留所有权利。
Introduction: Patients with stable coronary artery disease (CAD) are at risk of arterial thrombosis causing myocardial infarction. Detection of global haemostatic markers of hypercoagulability and hypofibrinolysis may be important for risk stratification and individualised treatment. We examined overall haemostatic potential (OHP) and thrombin generation in a group of stable CAD patients. We also sought to investigate associations between fibrinolytic inhibitors and abnormal global fibrinolysis in these patients.Materials and Methods: Blood samples were collected from 56 patients defined by coronary anatomy as symptomatically stable CAD. Medications were recorded. Samples were analysed using the global coagulation assays OHP and thrombin generation (calibrated automated thrombogram, CAT), platelet aggregometry measured by Multiplate (R), and levels of plasminogen activator inhibitor-1 (PAI-1) antigen measured by ELISA. Results were compared with a reference group of healthy controls.Results: Stable CAD patients displayed increased fibrin and thrombin generation and impaired fibrinolysis (decreased overall fibrinolytic potential, OFP, and increased clot lysis time) compared with healthy controls. No effect of antiplatelet agents or other medications on these parameters was observed using platelet-poor plasma. After multivariate adjustment, OFP of healthy individuals was significantly associated with fibrinogen, but in CAD patients PAI-1 became an important determinant.Conclusions: Hypercoagulability of plasma is observed in stable CAD, with both increased thrombin generation and reduced fibrinolytic potential making a significant contribution. The OHP assay may provide a simple method of identifying hypercoagulability in individual patients. (C) 2013 Elsevier Ltd. All rights reserved.