TY - JOUR
T1 - Biomarkers of coagulation and fibrinolysis in acute myocardial infarction
T2 - a joint position paper of the Association for Acute CardioVascular Care and the European Society of Cardiology Working Group on Thrombosis
AU - Krychtiuk, Konstantin A
AU - Speidl, Walter S
AU - Giannitsis, Evangelos
AU - Gigante, Bruna
AU - Gorog, Diana A
AU - Jaffe, Allan S
AU - Mair, Johannes
AU - Möckel, Martin
AU - Mueller, Christian
AU - Storey, Robert F
AU - Vilahur, Gemma
AU - Wojta, Johann
AU - Huber, Kurt
AU - Halvorsen, Sigrun
AU - Geisler, Tobias
AU - Morais, Joao
AU - Lindahl, Bertil
AU - Thygesen, Kristian
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected].
PY - 2021/3
Y1 - 2021/3
N2 - The formation of a thrombus in an epicardial artery may result in an acute myocardial infarction (AMI). Despite major advances in acute treatment using network approaches to allocate patients to timely reperfusion and optimal antithrombotic treatment, patients remain at high risk for thrombotic complications. Ongoing activation of the coagulation system as well as thrombin-mediated platelet activation may both play a crucial role in this context. Whether measurement of circulating biomarkers of coagulation and fibrinolysis could be useful for risk stratification in secondary prevention is currently not fully understood. In addition, measurement of such biomarkers could be helpful to identify thrombus formation as the leading mechanism for AMI. The introduction of biomarkers of myocardial injury such as high-sensitivity cardiac troponins made rule-out of AMI even more precise. However, elevated markers of myocardial injury cannot provide proof of a type 1 AMI, let alone thrombus formation. The combined measurement of markers of myocardial injury with biomarkers reflecting ongoing thrombus formation might be helpful for the fast and correct diagnosis of an atherothrombotic type 1 AMI. This position paper gives an overview of the current knowledge and possible role of biomarkers of coagulation and fibrinolysis for the diagnosis of AMI, risk stratification, and individualized treatment strategies in patients with AMI.
AB - The formation of a thrombus in an epicardial artery may result in an acute myocardial infarction (AMI). Despite major advances in acute treatment using network approaches to allocate patients to timely reperfusion and optimal antithrombotic treatment, patients remain at high risk for thrombotic complications. Ongoing activation of the coagulation system as well as thrombin-mediated platelet activation may both play a crucial role in this context. Whether measurement of circulating biomarkers of coagulation and fibrinolysis could be useful for risk stratification in secondary prevention is currently not fully understood. In addition, measurement of such biomarkers could be helpful to identify thrombus formation as the leading mechanism for AMI. The introduction of biomarkers of myocardial injury such as high-sensitivity cardiac troponins made rule-out of AMI even more precise. However, elevated markers of myocardial injury cannot provide proof of a type 1 AMI, let alone thrombus formation. The combined measurement of markers of myocardial injury with biomarkers reflecting ongoing thrombus formation might be helpful for the fast and correct diagnosis of an atherothrombotic type 1 AMI. This position paper gives an overview of the current knowledge and possible role of biomarkers of coagulation and fibrinolysis for the diagnosis of AMI, risk stratification, and individualized treatment strategies in patients with AMI.
KW - AMI
KW - Biomarkers
KW - Fibrinolysis
KW - Myocardial infarction
KW - Thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85119241972&partnerID=8YFLogxK
U2 - 10.1093/ehjacc/zuaa025
DO - 10.1093/ehjacc/zuaa025
M3 - Journal article
C2 - 33620437
SN - 2048-8726
VL - 10
SP - 343
EP - 355
JO - European Heart Journal: Acute Cardiovascular Care
JF - European Heart Journal: Acute Cardiovascular Care
IS - 3
ER -