Abstract
Endogenous fibrinolysis is a powerful natural defense mechanism against lasting arterial thrombotic occlusion. Recent prospective studies have shown that impaired endogenous fibrinolysis (or hypofibrinolysis) can be detected in a significant number of patients with acute coronary syndrome (ACS) using global assays and is a strong marker of future cardiovascular risk. This novel risk biomarker is independent of traditional cardiovascular risk factors and unaffected by antiplatelet therapy. Most prospective prognostic data have been obtained using a global assay using native whole blood at high shear or plasma turbidimetric assays, which are described herein. Tests of endogenous fibrinolysis could be used to identify patients with ACS who, despite antiplatelet therapy, remain at high cardiovascular risk. This review discusses the impact of currently available medications and those in development that favorably modulate fibrinolytic status and may offer a potential new avenue to improve outcomes in ACS.
| Original language | English |
|---|---|
| Pages (from-to) | 1366-1375 |
| Number of pages | 10 |
| Journal | Journal of the American College of Cardiology |
| Volume | 74 |
| Issue number | 10 |
| Early online date | 2 Sept 2019 |
| DOIs | |
| Publication status | Published - 10 Sept 2019 |
Keywords
- acute coronary syndrome
- fibrinolysis
- risk factor
- thrombolysis
- thrombosis