Correlation between coronary morphology and molecular markers of fibrinolysis in unstable angina pectoris

Hoffmeister, Hans Martin; Jur, M.; Helber, Uwe; Fischer, Marcus; Heller, W.; Seipel, L

doi:10.1016/s0021-9150(99)00049-0

Cited by 22 publications

(5 citation statements)

References 38 publications

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“…To the best of ourknowledge,the presentstudyisthe firsttoreportanassociation betweencarotidplaque morphology and t-PA antigen. This novelo bservation is supportedb yapositivec orrelation between t-PA andmorphological complexityofculprit lesions assessed by coronaryangiography in patients with unstable angina ( 27). In agreementw ith previouss tudies,w eo bserveda simultaneousincrease in circulatingt-PAagand vWFagwhichreflects endothelial dysfunction (7,8), an ongoing prothrombotic stateand an increased riskofthrombotice vents (28).…”

Section: Discussionsupporting

confidence: 61%

Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques

Mathiesen¹,

Amiral²,

Vissac³

et al. 2006

Thromb Haemost

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Echolucent carotid plaques are associated with high risk for future ischemic cerebrovascular events independent of the degree of stenosis. Elevated levels of markers of systemic inflammation and endothelial dysfunction are predictors for future myocardial infarction and stroke. The present study was undertaken to investigate the relations between plaque morphology, endothelial dysfunction assessed by tissue-plasminogen activator antigen (t-PA ag) and vonWillebrand factor (vWF), and systemic inflammation in persons with carotid stenosis. We conducted a crosssectional study including 133 persons with carotid stenosis and 138 controls without stenosis recruited from the populationbased Tromsø Study. High-resolution B-mode and colour Doppler/pulsed-wave Doppler ultrasonography of both carotid arteries was performed, and plaque morphology in terms of echogenicity was assessed. Persons with carotid stenosis had significantly higher plasma t-PA and vWF concentrations than controls. There was a significant inverse relationship between t-PA ag and plaque echogenicity (p = 0.034). The increased plasma t-PA ag in persons with carotid stenosis was not associated with increased plasminogen activator inhibitor-I (PAI-1). Persons with echolucent carotid plaques had higher degree of systemic inflammation, and plasma t-PA and vWF concentration increased significantly across quartiles of WBC, fibrinogen, and hs-CRP. Our findings may suggest that plasma t-PA may be superior to vWF as a marker for endothelial dysfunction due to its ability to discriminate between various plaque echogenicity, and that the predictive role of t-PA ag in cardiovascular disease is independent of inhibited fibrinolysis.

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Section: Discussionsupporting

confidence: 61%

Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques

Mathiesen¹,

Amiral²,

Vissac³

et al. 2006

Thromb Haemost

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“…This finding of an association is in accordance with reports, in which levels of both molecules were determined on admission and were found to be useful prognostic markers (2,11). A link between both findings might be the positive relationship between the extent of an altered TPA-system and the morphological complexity of the culprit coronary artery stenosis (21). A further explanation is the association between cardiac troponin status and CRP as marker of the acute phase reaction (22): the slight increase of TPA within the first 48 h may be due to stimulated PAI-1 secretion and may thus have a prothrombotic action.…”

Section: Plasminogen Activator Systemssupporting

confidence: 92%

Myocardial Troponin T Release Is Associated with Enhanced Fibrinolysis in Patients with Acute Coronary Syndromes

Ehlers

Büttcher²,

Kazmaier³

et al. 2001

Thromb Haemost

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SummaryPatients with acute coronary syndromes (ACS) frequently present with signs of disturbed fibrinolysis. The present study investigates the correlation of alterations in the fibrinolytic system and the amount of myocardial damage characterized by troponin release.In 85 patients with ACS markers of plasmin activation, plasminogen activator system and troponin T (TnT) were measured initially and after 48 h. Patients with TnT release (≥ 0.01 g/l) at admission had higher TPA levels than those without release (10.2 ± 0.7 ng/ml vs. 7.6 ± 0.5 ng/ml; p <0.01). Additionally, patients with positive TnT had higher D-dimer levels initially (457 ± 39 ng/ml vs. 316 ± 22 ng/ml; p < 0.01) and 48 h later (451 ± 42 ng/ml vs. 275 ± 37 ng/ml; p < 0.01). The association of myocardial damage with a prothrombotic state and an enhanced fibrinolysis may explain the high prognostic value of troponin measurements in respect to future coronary events.

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“…Several epidemiological studies have proposed that elevated levels of molecular markers of thrombin generation, such as D-dimers, are risk indicators for future cardiovascular events in apparently healthy men [23,24]. Previous studies reported divergent results with regard to D-dimer in the ACS setting [25][26][27][28]. Some of those studies have shown that D-dimer levels were an additional marker for adverse coronary events, but others have not reported such a result.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of elevated D-dimer in patients undergoing primary angioplasty for ST elevation myocardial infarction

Akgül¹,

Uyarel²,

Püşüroğlu³

et al. 2013

Blood Coagulation &Amp; Fibrinolysis

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The aim of this study was to evaluate the prognostic value of D-dimer in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). The prognostic value of D-dimer has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We prospectively enrolled 453 consecutive STEMI patients (mean age 55.6 ± 12.4 years, 364 male, 89 female) undergoing primary PCI. The study population was divided into tertiles based on admission D-dimer values. The high D-dimer group (n = 151) was defined as a value in the third tertile [>0.72 ug/ml fibrinogen equivalent units (FEU)], and the low D-dimer group (n = 302) included those patients with a value in the lower two tertiles (≤0.72 ug/ml FEU). Clinical characteristics, in-hospital and 6-month outcomes of primary PCI were analyzed. The patients of the high D-dimer group were older (mean age 60.1 ± 13.5 versus 52.4 ± 10.6, P < 0.001). Higher in-hospital cardiovascular mortality and 6-month all-cause mortality rates were observed in the high D-dimer group (7.2 versus 0.6%, P < 0.001 and 13.9 versus 2%, P < 0.001, respectively). In Cox multivariate analysis; a high admission D-dimer value (>0.72 ug/ml FEU) was found to be a powerful independent predictor of 6-month all-cause mortality (odds ratio: 10.1, 95% confidence interval: 1.24-42.73, P = 0.03). These results suggest that a high admission D-dimer, level was associated with increased in-hospital cardiovascular mortality and 6-month all-cause mortality in patients with STEMI undergoing primary PCI.

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Correlation between coronary morphology and molecular markers of fibrinolysis in unstable angina pectoris

Cited by 22 publications

References 38 publications

Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques

Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques

Myocardial Troponin T Release Is Associated with Enhanced Fibrinolysis in Patients with Acute Coronary Syndromes

Predictive value of elevated D-dimer in patients undergoing primary angioplasty for ST elevation myocardial infarction

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