Show simple item record

dc.contributor.authorSpinthakis, Nikolaos
dc.contributor.authorGue, Ying
dc.contributor.authorFarag, Mohamed
dc.contributor.authorRen, Guogang
dc.contributor.authorSrinivasan, Manivannan
dc.contributor.authorBaydoun, Anwar
dc.contributor.authorGorog, Diana A
dc.date.accessioned2019-04-16T14:09:34Z
dc.date.available2019-04-16T14:09:34Z
dc.date.issued2019-04-01
dc.identifier.citationSpinthakis , N , Gue , Y , Farag , M , Ren , G , Srinivasan , M , Baydoun , A & Gorog , D A 2019 , ' Impaired endogenous fibrinolysis at high shear using a point-of-care test in STEMI is associated with alterations in clot architecture ' , Journal of Thrombosis and Thrombolysis , vol. 47 , no. 3 , pp. 392-395 . https://doi.org/10.1007/s11239-018-01799-1
dc.identifier.issn0929-5305
dc.identifier.otherPURE: 16553215
dc.identifier.otherPURE UUID: f110ef8e-d0f4-463c-a8df-e36852ed595c
dc.identifier.otherPubMed: 30739303
dc.identifier.otherScopus: 85061345194
dc.identifier.otherORCID: /0000-0001-8865-1526/work/62749447
dc.identifier.urihttp://hdl.handle.net/2299/21273
dc.description© The Author(s) 2019
dc.description.abstractImpaired endogenous fibrinolysis is an adverse prognostic biomarker in acute coronary syndrome (ACS). Abnormally dense in vitro fibrin thrombi have been demonstrated in ACS patients and related to hypofibrinolysis using cumbersome, laboratory-based methods. We aimed to assess endogenous fibrinolysis using a point-of-care technique and relate this to clot architecture. From patients with ST-segment elevation myocardial infarction (STEMI), venous blood was drawn immediately on arrival to assess thrombotic status. Blood was assessed using the point-of-care Global Thrombosis Test which measures occlusive thrombus formation under high shear and subsequently endogenous fibrinolysis (lysis time, LT). Two samples per patient were run in parallel. In one channel, the measurement was allowed to proceed as normal. In the other, after occlusion, thrombus was extracted, washed, fixed in glutaraldehyde, dried, sputter-coated, and assessed using scanning electron microscope. Endogenous fibrinolysis was strongly associated fibrin fibre thickness (p = 0.0001). As LT increased (less efficient fibrinolysis), the fibrin network of the thrombus was significantly more compact and dense, with thinner fibrin fibres and smaller gaps. Fibrin fibre thickness correlated inversely with LT (r = - 0.89, p = 0.001). Adverse clot architecture in vitro is directly related to impaired endogenous fibrinolysis using a relatively new point-of-care technique in patients with STEMI. This may transform the relevance of fibrin clot architecture from an off-line laboratory association to being directly relevant to endogenous fibrinolysis at the patient bedside, which could be used as a near-patient test to guide prognosis and assess the effect of treatment.en
dc.format.extent4
dc.language.isoeng
dc.relation.ispartofJournal of Thrombosis and Thrombolysis
dc.subjectHematology
dc.subjectCardiology and Cardiovascular Medicine
dc.titleImpaired endogenous fibrinolysis at high shear using a point-of-care test in STEMI is associated with alterations in clot architectureen
dc.contributor.institutionMaterials and Structures
dc.contributor.institutionSchool of Engineering and Technology
dc.contributor.institutionCentre for Engineering Research
dc.contributor.institutionBioEngineering
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85061345194&partnerID=8YFLogxK
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1007/s11239-018-01799-1
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record