Impaired Spontaneous/Endogenous Fibrinolytic Status as New Cardiovascular Risk Factor? JACC Review Topic of the Week

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:74

Review

Gorog, Diana A.^1,2  Lip, Gregory Y. H.^3,4,5 

[1] Imperial Coll, Natl Heart & Lung Inst, London, England

[2] Univ Hertfordshire, Postgrad Med Sch, Hatfield, Herts, England

[3] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England

[4] Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England

[5] Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark

关键词: acute coronary syndrome;    fibrinolysis;    risk factor;    thrombolysis;    thrombosis;   

DOI  :  10.1016/j.jacc.2019.07.030

来源: Elsevier

【 摘 要 】

Endogenous fibrinolysis is a powerful natural defense mechanism against lasting arterial thrombotic occlusion. Recent prospective studies have shown that impaired endogenous fibrinolysis (or hypofibrinolysis) can be detected in a significant number of patients with acute coronary syndrome (ACS) using global assays and is a strong marker of future cardiovascular risk. This novel risk biomarker is independent of traditional cardiovascular risk factors and unaffected by antiplatelet therapy. Most prospective prognostic data have been obtained using a global assay using native whole blood at high shear or plasma turbidimetric assays, which are described herein. Tests of endogenous fibrinolysis could be used to identify patients with ACS who, despite antiplatelet therapy, remain at high cardiovascular risk. This review discusses the impact of currently available medications and those in development that favorably modulate fibrinolytic status and may offer a potential new avenue to improve outcomes in ACS. Crown Copyright (C) 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation. All rights reserved.

【 授权许可】

Free