Determinants of Endogenous Fibrinolysis in Whole Blood Under High Shear in Patients With Myocardial Infarction

Rahim Kanji, MB, BS; Ying X. Gue, MB, BS, PhD; Mohamed F. Farag, MB, BS, PhD; Neil H. Spencer, PhD; Nicola J. Mutch, BSc, PhD; Diana A. Gorog, MD, PhD

JACC: Basic to Translational Science (Nov 2022)

Determinants of Endogenous Fibrinolysis in Whole Blood Under High Shear in Patients With Myocardial Infarction

Rahim Kanji, MB, BS,
Ying X. Gue, MB, BS, PhD,
Mohamed F. Farag, MB, BS, PhD,
Neil H. Spencer, PhD,
Nicola J. Mutch, BSc, PhD,
Diana A. Gorog, MD, PhD

Affiliations

Rahim Kanji, MB, BS: Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom; Cardiology Department, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, United Kingdom
Ying X. Gue, MB, BS, PhD: Cardiology Department, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, United Kingdom; School of Life and Medical Sciences, Postgraduate Medical School, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom
Mohamed F. Farag, MB, BS, PhD: Cardiology Department, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, United Kingdom; School of Life and Medical Sciences, Postgraduate Medical School, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom
Neil H. Spencer, PhD: Statistical Services and Consultancy Unit, Hertfordshire Business School, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom
Nicola J. Mutch, BSc, PhD: Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
Diana A. Gorog, MD, PhD: Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom; Cardiology Department, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, United Kingdom; School of Life and Medical Sciences, Postgraduate Medical School, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom; Address for correspondence: Prof Diana A. Gorog, Faculty of Medicine, National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom.

Journal volume & issue: Vol. 7, no. 11
pp. 1069 – 1082

Abstract

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Summary: Hypofibrinolysis is a recently-recognized risk factor for recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI), but the mechanistic determinants of this are not well understood. In patients with STEMI, we show that the effectiveness of endogenous fibrinolysis in whole blood is determined in part by fibrinogen level, high sensitivity C-reactive protein, and shear-induced platelet reactivity, the latter directly related to the speed of thrombin generation. Our findings strengthen the evidence for the role of cellular components and bidirectional crosstalk between coagulatory and inflammatory pathways as determinants of hypofibrinolysis.

Published in JACC: Basic to Translational Science

ISSN: 2452-302X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-basic-to-translational-science/

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