Tissue factor pathway inhibitor is an early biomarker of myocardial injury in patients with ST-segment elevation acute myocardial infarction

Sambola, Antonia; Francisco, Jaume; Blanco, Bruno García del; Aguadé, S; Candell‐Riera, Jaume; Martí, Gerard; Figueras, Jaume; Barrabés, José A.; Millán, Xavier; Garcı́a-Dorado, David

doi:10.1016/j.ijcard.2013.12.240

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Furthermore, a thrombogenic environment has been associated with cardiovascular diseases (28)(29)(30)(31)(32)(33)(34). We found elevated levels of We found elevated circulating plasma levels of PAI-1, D-dimer, t-PA and lower levels of plasmin in these patients compared with those sensitive to fibrinolysis.…”

Section: Figure 5: Response To Fibrinolysis According To Ischaemic Timentioning

confidence: 51%

“…Experimental studies provided insight about the impact of the elapsed onset-of-pain-to-PCI time and hence of clot age (22)(23)(24). PAI-1, t-PA and D-dimer in peripheral blood that previously have been described as a trend to paradoxical response from systemic blood to lysis a resistant thrombus with a higher endogenous formation of ineffective lytic factors (31). Elevated t-PA and PAI-1 levels have been associated with increased thrombotic arterial disease, and it has been demonstrated that a large amount of PAI-1 is stored in platelet-rich thrombi resistant to fibrinolysis (29,31).…”

Section: Figure 5: Response To Fibrinolysis According To Ischaemic Timentioning

confidence: 99%

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Increased von Willebrand factor, P-selectin and fibrin content in occlusive thrombus resistant to lytic therapy

Sambola¹,

Blanco²,

Ruiz‐Meana³

et al. 2016

Thromb Haemost

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Therapeutic fibrinolysis is ineffective in 40 % of ST-segment elevation acute myocardial infarction (STEMI) patients, but understanding of the mechanisms is incomplete. It was our aim to compare the composition of coronary thrombus in lysis-resistant STEMI patients with that of lysis-sensitive patients. Intracoronary thrombi (n=64) were obtained by aspiration in consecutive STEMI patients. Of them, 20 had received fibrinolysis and underwent rescue percutaneous coronary intervention (r-PCI, lysis-resistant patients) and 44 underwent primary PCI (p-PCI). Lysis-sensitivity was determined in vitro by clot permeability measurements and turbidimetric lysis in plasma of 44 patients undergoing p-PCI and 20 healthy donors. Clot-lysis sensitivity was defined as a clot-lysis time not greater than 1 SD over the mean of healthy donors. Coronary thrombus composition in 20 lysis-resistant and in 20 lysis-sensitive patients was analysed by immunofluorescence with confocal microscopy. Plasma biomarkers (P-selectin, VWF, PAI-1, t-PA, D-dimer, TF pathway markers, plasmin and CD34+) were measured simultaneously on peripheral blood. Lysis-resistant clots had higher levels of fibrin (p=0.02), P-selectin (p=0.03) and VWF (p=0.01) than lysis-sensitive clots. Among thrombi obtained ≤ 6 hours after onset of symptoms, those from lysis-resistant patients showed a higher content in fibrin than those from p-PCI patients (p=0.01). Plasma PAI-1 (p=0.02) and D-dimer levels were significantly higher (p=0.003) in lysis-resistant patients, whereas plasmin levels were lower (p=0.03). Multivariate analysis showed the content of fibrin and VWF within thrombus as predictors of thrombolysis resistance. In conclusion, coronary thrombi in STEMI patients resistant to fibrinolysis are characterised by higher fibrin, P-selectin and VWF content than lysis-sensitive thrombi.

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Section: Figure 5: Response To Fibrinolysis According To Ischaemic Timentioning

confidence: 51%

Section: Figure 5: Response To Fibrinolysis According To Ischaemic Timentioning

confidence: 99%

Increased von Willebrand factor, P-selectin and fibrin content in occlusive thrombus resistant to lytic therapy

Sambola¹,

Blanco²,

Ruiz‐Meana³

et al. 2016

Thromb Haemost

Self Cite

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“…This was also observed in a primate model and in ARDS patients, where TFPI increased during progression of disease after severe endothelial injury 27 . Thus, increased levels of TFPI in plasma might probably result from cleavage during coagulation activation 32 , 33 or from release due to endothelial dysfunction 34 and endothelial pathology, as suggested in patients with burns 35 or STEMI 36 . This could explain the increase of TPFI plasma levels, which usually accounts for only approximately 20% of total TFPI 31 , 37 .…”

Section: Discussionmentioning

confidence: 99%

Associations of tissue factor and tissue factor pathway inhibitor with organ dysfunctions in septic shock

Lehner,

Tobiasch,

Perschinka

et al. 2024

Sci Rep

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Coagulopathy, microvascular alterations and concomitant organ dysfunctions are hallmarks of sepsis. Attempts to attenuate coagulation activation with an inhibitor of tissue factor (TF), i.e. tissue factor pathway inhibitor (TFPI), revealed no survival benefit in a heterogenous group of sepsis patients, but a potential survival benefit in patients with an international normalized ratio (INR) < 1.2. Since an increased TF/TFPI ratio determines the procoagulant activity specifically on microvascular endothelial cells in vitro, we investigated whether TF/TFPI ratio in blood is associated with INR alterations, organ dysfunctions, disseminated intravascular coagulation (DIC) and outcome in septic shock. Twenty-nine healthy controls (HC) and 89 patients with septic shock admitted to a tertiary ICU were analyzed. TF and TFPI in blood was analyzed and related to organ dysfunctions, DIC and mortality. Patients with septic shock had 1.6-fold higher levels of TF and 2.9-fold higher levels of TFPI than HC. TF/TFPI ratio was lower in septic shock compared to HC (0.003 (0.002–0.005) vs. 0.006 (0.005–0.008), p < 0.001). Non-survivors had higher TFPI levels compared to survivors (43038 (29354–54023) vs. 28041 (21675–46582) pg/ml, p = 0.011). High TFPI levels were associated with acute kidney injury, liver dysfunction, DIC and disease severity. There was a positive association between TF/TFPI ratio and troponin T (b = 0.531 (0.309–0.754), p < 0.001). A high TF/TFPI ratio is exclusively associated with myocardial injury but not with other organ dysfunctions. Systemic TFPI levels seem to reflect disease severity. These findings point towards a pathophysiologic role of TF/TFPI in sepsis-induced myocardial injury.

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Glycative and oxidative stress are associated with altered thrombus composition in diabetic patients with ST-elevation myocardial infarction

Sambola

Ruiz‐Meana

Barba

et al. 2017

International Journal of Cardiology

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Tissue factor pathway inhibitor is an early biomarker of myocardial injury in patients with ST-segment elevation acute myocardial infarction

Cited by 3 publications

References 9 publications

Increased von Willebrand factor, P-selectin and fibrin content in occlusive thrombus resistant to lytic therapy

Increased von Willebrand factor, P-selectin and fibrin content in occlusive thrombus resistant to lytic therapy

Associations of tissue factor and tissue factor pathway inhibitor with organ dysfunctions in septic shock

Glycative and oxidative stress are associated with altered thrombus composition in diabetic patients with ST-elevation myocardial infarction

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