Research output: Contribution to journal › Review article › peer-review
Arterial Thrombus Stability : Does It Matter and Can We Detect It? / Gorog, Diana A; Fayad, Zahi A; Fuster, Valentin.
In: Journal of the American College of Cardiology, Vol. 70, No. 16, 17.10.2017, p. 2036-2047.Research output: Contribution to journal › Review article › peer-review
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TY - JOUR
T1 - Arterial Thrombus Stability
T2 - Does It Matter and Can We Detect It?
AU - Gorog, Diana A
AU - Fayad, Zahi A
AU - Fuster, Valentin
N1 - © 2017 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION.PUBLISHED BY ELSEVIER. ALL RIGHTS RESERVED
PY - 2017/10/17
Y1 - 2017/10/17
N2 - The spontaneous lysis of a coronary thrombus is a natural protective mechanism against lasting occlusion and downstream infarction. Thrombus stability is thus a direct determinant of clinical outcome. Compared with the extensive study of the crucial role of platelets, coagulation, and flow in arterial thrombosis, little attention has been paid to factors affecting thrombus stability, despite evidence linking impaired spontaneous fibrinolytic activity with acute coronary events. We summarize experimental evidence for the importance of thrombus stability and highlight the need for physiologically relevant tests to assess spontaneous disintegration/fibrinolysis of platelet-rich thrombi under arterial flow conditions, review techniques to assess thrombus stability in vitro, and describe novel imaging techniques to characterize thrombosis in vivo. Such techniques may allow tailoring of pharmacotherapy to potentiate thrombus instability, through fragmentation of platelet thrombi and/or enhanced endogenous fibrinolysis, to reduce infarct size.
AB - The spontaneous lysis of a coronary thrombus is a natural protective mechanism against lasting occlusion and downstream infarction. Thrombus stability is thus a direct determinant of clinical outcome. Compared with the extensive study of the crucial role of platelets, coagulation, and flow in arterial thrombosis, little attention has been paid to factors affecting thrombus stability, despite evidence linking impaired spontaneous fibrinolytic activity with acute coronary events. We summarize experimental evidence for the importance of thrombus stability and highlight the need for physiologically relevant tests to assess spontaneous disintegration/fibrinolysis of platelet-rich thrombi under arterial flow conditions, review techniques to assess thrombus stability in vitro, and describe novel imaging techniques to characterize thrombosis in vivo. Such techniques may allow tailoring of pharmacotherapy to potentiate thrombus instability, through fragmentation of platelet thrombi and/or enhanced endogenous fibrinolysis, to reduce infarct size.
KW - Coronary Thrombosis
KW - Fibrinolysis
KW - Humans
KW - Magnetic Resonance Imaging, Cine
KW - Multimodal Imaging
KW - Thrombolytic Therapy
KW - Thrombosis
KW - Journal Article
KW - Review
U2 - 10.1016/j.jacc.2017.08.065
DO - 10.1016/j.jacc.2017.08.065
M3 - Review article
C2 - 29025561
VL - 70
SP - 2036
EP - 2047
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 16
ER -