Plasma Soluble Fibrin Monomer Complex as a Marker of Coronary Thrombotic Events in Patients with Acute Myocardial Infarction
Plasma Soluble Fibrin Monomer Complex as a Marker of Coronary Thrombotic Events in Patients with Acute Myocardial Infarction
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DOI：
10.1620/tjem.219.25
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发表时间：
2009-09-01
影响因子：
2.2
通讯作者：
Oguma, Yutaka
中科院分区：
文献类型：
--
作者：
Ieko, Masahiro;Naito, Sumiyoshi;Oguma, Yutaka
可溶性纤维蛋白单体在血液凝固的极早期阶段出现在血流中，并且通常与纤维蛋白原形成复合物，称为可溶性纤维蛋白单体复合物（FMC）。FMC的测定可以提供血栓性疾病的状态信息，因此研究FMC是否可作为心肌梗死（MI）的早期指标非常重要。我们研究了止血和纤溶参数，包括FMC，以确定其指示冠状动脉血栓形成条件的能力。分别在MI发作后48小时（急性期）和120 - 600小时（恢复期）内采集47例急性MI患者的血样。与恢复期和健康对照组相比，急性期血浆FMC显著升高（p = 0.001），表明其升高表明MI患者冠状动脉中发生血栓形成事件。D-二聚体是血栓形成伴纤维蛋白溶解的标志物，在患者的两个阶段均增加。此外，与24 - 48小时相比，在发病后24小时内，FMC和D-二聚体显著增加（p = 0.003和p = 0.011）。此外，心肌肌钙蛋白T（心肌损伤的标志物）在24小时后显著高于前24小时（p = 0.001）。受试者工作特征（ROC）分析表明，FMC，而不是D-二聚体，是一个更好的标记物在发病后24小时内的早期MI诊断的FMC。测定血浆FMC有助于MI复发的早期诊断和初步治疗方案的制定。
Soluble fibrin monomer appears in the bloodstream during the extremely early stage of blood coagulation and generally forms a complex with fibrinogen, termed soluble fibrin monomer complex (FMC). Determination of FMC can provide information regarding the state of thrombotic diseases; thus it is important to investigate whether FMC serves as an early indicator of myocardial infarction (MI). We investigated hemostatic and fibrinolytic parameters including FMC to determine their capabilities for indicating thrombotic conditions in the coronary artery. Blood samples from 47 patients with acute MI were obtained within 48 hours (acute phase) and during 120 - 600 hours (recovery phase), respectively, after MI onset. Plasma FMC was significantly elevated in the acute phase, compared with that during the recovery phase and in healthy controls (p = 0.001), suggesting that its elevation indicates thrombotic events in the coronary artery of MI patients. D-dimer, a marker of thrombus formation accompanied with fibrinolysis, was increased in both phases in the patients. In addition, FMC and D-dimer were significantly increased within 24 hours after onset as compared to 24 - 48 hours (p = 0.003 and p = 0.011). Furthermore, cardiac troponin T, a marker of myocardial damage, was significantly higher after 24 hours than within the first 24 hours (p = 0.001). Receiver operating characteristic (ROC) analysis of FMC for early MI diagnosis indicates that FMC, rather than D-dimer, is a better marker within 24 hours of onset. Measuring plasma FMC may be useful for early diagnosis of MI recurrence and deciding primary treatment.