Impaired endogenous fibrinolysis in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention is a predictor of recurrent cardiovascular events: the RISK PPCI study

Abstract

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Rationale and design of “Can Very Low Dose Rivaroxaban (VLDR) in addition to dual antiplatelet therapy improve thrombotic status in acute coronary syndrome (VaLiDate-R)” study

“…Unlike the enhanced platelet reactivity in these patients which reduced from admission to discharge, presumably reflecting the onset of effect of antiplatelet therapy, fibrinolysis in ACS patients appears unaffected by DAPT [15,16]. Our group has previously investigated the effects of P2Y 12 inhibitors on endogenous fibrinolysis and shown that these agents appear to have minimal impact on fibrinolysis [18].…”

“…with hazard increasing with increasing lysis time [17]. More recently, the RISK PPCI study from our group, involving nearly 500 patients with ST-segment elevation myocardial infarction (STEMI) showed that impaired endogenous fibrinolysis (LT ≥ 2500 s) detected in 14% patients on admission was strongly related to recurrent major cardiovascular events (HR 9.1, 95% CI 4.28-15.03, p = 0.001), driven by cardiovascular death and myocardial infarction [16].…”

“…Altered fibrin clot structure and increased resistance of the clot to lysis have been associate with myocardial infarction and stent thrombosis [11][12][13][14]. In the last 2 years, two large prospective studies have confirmed that impaired fibrinolysis in patients with ACS is a novel independent marker of increased cardiovascular risk [15,16]. In a sub-study of > 4000 patients in the PLATO trial, assessment of fibrin clot lysis using a validated turbidimetric assay revealed that impaired fibrin clot lysis was an independent predictor of adverse outcome in ACS [15].…”

<p>LINC00491 as a new molecular marker can promote the proliferation, migration and invasion of colon adenocarcinoma cells</p>

“…Amongst the pathways identified, protease binding, fibrinolysis, and platelet degranulation have been shown to be involved in cancer pathogenesis. [15][16][17][18][19] LINC00491 promotes colon adenocarcinoma cell proliferation, migration and invasion…”

Comparison of Shear Stress–Induced Thrombotic and Thrombolytic Effects Among 3 Different Antithrombotic Regimens in Patients With Acute Coronary Syndrome

“…[8][9][10] Recent prospective studies have shown that impaired endogenous thrombolysis can be detected in a significant number of patients with ACS using the GTT and that it is a reliable marker of future cardiovascular risk. [11][12][13] Ticagrelor is the most commonly recommended P2Y12 inhibitor in ACS, and very-low-dose rivaroxaban is currently the only proven oral direct thrombin inhibitor in ACS, while CLP is still widely used in patients with ACS in real-world practice, especially in Korea. [14][15][16] Nevertheless, a direct comparison of the antithrombotic efficacy under in vitro SS conditions among these 3 common strategies has not yet been performed.…”