Endogenous fibrinolysis-Relevance to clinical thrombosis risk assessment.
Acute Coronary Syndrome
/ blood
Arteries
COVID-19
/ blood
Coronary Thrombosis
/ blood
Fibrin Clot Lysis Time
Fibrinolysis
/ physiology
Hematologic Tests
Humans
Ischemic Stroke
/ blood
Myocardial Infarction
/ blood
Risk Assessment
SARS-CoV-2
Thrombelastography
Thrombosis
/ blood
Venous Thromboembolism
/ blood
Venous Thrombosis
/ blood
acute coronary syndrome
clot lysis
fibrinolysis
stroke
thrombosis
venous thrombosis
Journal
European journal of clinical investigation
ISSN: 1365-2362
Titre abrégé: Eur J Clin Invest
Pays: England
ID NLM: 0245331
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
18
10
2020
revised:
05
12
2020
accepted:
06
12
2020
pubmed:
10
12
2020
medline:
30
11
2021
entrez:
9
12
2020
Statut:
ppublish
Résumé
The development of an obstructive luminal thrombus is pathological and considered a failure of endogenous fibrinolysis. The consequences may be fatal, or result in lasting downstream organ damage. Therefore, assessment of endogenous fibrinolytic status in an individual may identify those at risk of occlusive thrombus formation and provide prognostic information. Arterial thrombi are more platelet rich and more resistant to fibrinolysis than venous thrombi. Several recent studies using global tests of fibrinolysis in patients with acute coronary syndromes (ACS) have shown that despite dual antiplatelet therapy, patients with impaired fibrinolytic status have an increased risk of adverse cardiovascular events, compared with those with effective fibrinolytic function. Such data add significantly to the predictive value of established cardiovascular risk factors and conventional biomarkers. Most data reported have been obtained with the Global Thrombosis Test and the turbidimetric plasma clot lysis assay. A few small studies in patients with ischaemic stroke suggest a similar predictive role of fibrinolytic status assessment in these patients. Studies reporting an association between impaired fibrinolysis and future venous thrombotic events are limited, and in the form of case-control studies. Viscoelastic assays may have a role in the prediction of venous thromboembolic risk. Assays of fibrinolytic function should be used to obtain a more accurate risk of future thrombotic events, particularly in the setting of ACS. The availability of point-of-care tests helps facilitate this and should encourage future studies to assess personalised antithrombotic treatment combinations to optimise fibrinolytic status and reduce thrombosis risk.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13471Informations de copyright
© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
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