Determinants of Endogenous Fibrinolysis in Whole Blood Under High Shear in Patients With Myocardial Infarction

Summary: Hypofibrinolysis is a recently-recognized risk factor for recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI), but the mechanistic determinants of this are not well understood. In patients with STEMI, we show that the effectiveness of endogeno...

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Bibliographic Details
Main Authors: Rahim Kanji, MB, BS, Ying X. Gue, MB, BS, PhD, Mohamed F. Farag, MB, BS, PhD, Neil H. Spencer, PhD, Nicola J. Mutch, BSc, PhD, Diana A. Gorog, MD, PhD
Format: Article
Language:English
Published: Elsevier 2022-11-01
Series:JACC: Basic to Translational Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2452302X22002145
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Summary:Summary: Hypofibrinolysis is a recently-recognized risk factor for recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI), but the mechanistic determinants of this are not well understood. In patients with STEMI, we show that the effectiveness of endogenous fibrinolysis in whole blood is determined in part by fibrinogen level, high sensitivity C-reactive protein, and shear-induced platelet reactivity, the latter directly related to the speed of thrombin generation. Our findings strengthen the evidence for the role of cellular components and bidirectional crosstalk between coagulatory and inflammatory pathways as determinants of hypofibrinolysis.
ISSN:2452-302X