Journal
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
Volume 10, Issue 3, Pages 343-355Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ehjacc/zuaa025
Keywords
AMI; Myocardial infarction; Biomarkers; Thrombosis; Fibrinolysis
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The formation of a thrombus in an epicardial artery may lead to AMI, and there is currently limited understanding of the role of circulating biomarkers of coagulation and fibrinolysis in secondary prevention.
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.
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