BACKGROUND: Because acute coronary syndromes (ACS) are caused by intracoronary thrombosis, plasma markers of coagulation have relevance for early diagnosis. AIMS AND OBJECTIVES: To provide a critical review of these studies and specific attempts to close the diagnostic time gap left by traditional plasma markers of heart injury. METHODS: Studies of ACS patients, with at least one control group, were included when blood samples were taken within 24 h after first symptoms prior to medication or intervention. Special attention was paid to studies reporting diagnostic performance, or combination of several markers into a single diagnostic index. RESULTS: Markers with short plasma half-life (FPA, TAT, etc.) reflect ongoing thrombosis and may identify patients at increased risk. Markers with longer half-life (F1+2, D-Dimer, etc.) may be more useful to indicate a single acute thrombotic event. However, results are highly variable and depend on sampling time, clot property, degree of coronary obstruction and physiological condition. Early diagnostic performance of hemostatic markers was poor even when combined with heart injury markers. CONCLUSIONS: Early measurement of hemostatic plasma markers in ACS patients provides pathophysiological information and may be helpful in risk stratification or to monitor anticoagulant therapy, but does not seem useful in routine clinical diagnosis of ACS.
BACKGROUND: Because acute coronary syndromes (ACS) are caused by intracoronary thrombosis, plasma markers of coagulation have relevance for early diagnosis. AIMS AND OBJECTIVES: To provide a critical review of these studies and specific attempts to close the diagnostic time gap left by traditional plasma markers of heart injury. METHODS: Studies of ACS patients, with at least one control group, were included when blood samples were taken within 24 h after first symptoms prior to medication or intervention. Special attention was paid to studies reporting diagnostic performance, or combination of several markers into a single diagnostic index. RESULTS: Markers with short plasma half-life (FPA, TAT, etc.) reflect ongoing thrombosis and may identify patients at increased risk. Markers with longer half-life (F1+2, D-Dimer, etc.) may be more useful to indicate a single acute thrombotic event. However, results are highly variable and depend on sampling time, clot property, degree of coronary obstruction and physiological condition. Early diagnostic performance of hemostatic markers was poor even when combined with heart injury markers. CONCLUSIONS: Early measurement of hemostatic plasma markers in ACS patients provides pathophysiological information and may be helpful in risk stratification or to monitor anticoagulant therapy, but does not seem useful in routine clinical diagnosis of ACS.
Authors: Dag G Ellingsen; Maxim Chashchin; Ingebjørg Seljeflot; Balazs Berlinger; Valery Chashchin; Leo Stockfelt; Yngvar Thomassen Journal: Int Arch Occup Environ Health Date: 2019-05-21 Impact factor: 3.015
Authors: Alexandra C Sundermann; Keith Saum; Kelsey A Conrad; Hannah M Russell; Todd L Edwards; Kevin Mani; Martin Björck; Anders Wanhainen; A Phillip Owens Journal: Blood Adv Date: 2018-11-27
Authors: Rinske Loeffen; René van Oerle; Mathie P G Leers; Johannes A Kragten; Harry Crijns; Henri M H Spronk; Hugo Ten Cate Journal: PLoS One Date: 2016-07-15 Impact factor: 3.240