dc.contributor.author | Lee, Seung Hun | |
dc.contributor.author | Kim, Hyun Kuk | |
dc.contributor.author | Ahn, Jong-Hwa | |
dc.contributor.author | Kang, Min Gyu | |
dc.contributor.author | Kim, Kye-Hwan | |
dc.contributor.author | Bae, Jae Seok | |
dc.contributor.author | Cho, Sang Young | |
dc.contributor.author | Koh, Jin-Sin | |
dc.contributor.author | Park, Yongwhi | |
dc.contributor.author | Hwang, Seok Jae | |
dc.contributor.author | Gorog, Diana | |
dc.contributor.author | Tantry, Udaya S. | |
dc.contributor.author | Bliden, Kevin P. | |
dc.contributor.author | Gurbel, Paul A | |
dc.contributor.author | Hwang, Jin-Yong | |
dc.contributor.author | Jeong, Young-Hoon | |
dc.date.accessioned | 2023-09-12T09:45:14Z | |
dc.date.available | 2023-09-12T09:45:14Z | |
dc.date.issued | 2023-05-14 | |
dc.identifier.citation | Lee , S H , Kim , H K , Ahn , J-H , Kang , M G , Kim , K-H , Bae , J S , Cho , S Y , Koh , J-S , Park , Y , Hwang , S J , Gorog , D , Tantry , U S , Bliden , K P , Gurbel , P A , Hwang , J-Y & Jeong , Y-H 2023 , ' Prognostic impact of hypercoagulability and impaired fibrinolysis in acute myocardial infarction ' , European Heart Journal , vol. 44 , no. 19 , pp. 1718-1728 . https://doi.org/10.1093/eurheartj/ehad088 | |
dc.identifier.issn | 0195-668X | |
dc.identifier.uri | http://hdl.handle.net/2299/26649 | |
dc.description | © 2023, Oxford University Press on behalf of the European Society of Cardiology. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1093/eurheartj/ehad088 | |
dc.description.abstract | AIMS: Atherothrombotic events are influenced by systemic hypercoagulability and fibrinolytic activity. The present study evaluated thrombogenicity indices and their prognostic implications according to disease acuity. METHODS AND RESULTS: From the consecutive patients undergoing percutaneous coronary intervention (PCI), those with thrombogenicity indices (n = 2705) were grouped according to disease acuity [acute myocardial infarction (AMI) vs. non-AMI]. Thrombogenicity indices were measured by thromboelastography (TEG). Blood samples for TEG were obtained immediately after insertion of the PCI sheath, and TEG tracing was performed within 4 h post-sampling. Major adverse cardiovascular events (MACE, a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke) were evaluated for up to 4 years. Compared with non-AMI patients, AMI patients had higher platelet-fibrin clot strength [maximal amplitude (MA): 66.5 ± 7.8 vs. 65.3 ± 7.2 mm, P < 0.001] and lower fibrinolytic activity [clot lysis at 30 min (LY30): 0.9 ± 1.8% vs. 1.1 ± 1.9%, P < 0.001]. Index AMI presentation was associated with MA [per one-mm increase: odds ratio (OR): 1.024; 95% confidence interval (CI): 1.013-1.036; P < 0.001] and LY30 (per one% increase: OR: 0.934; 95% CI: 0.893-0.978; P = 0.004). The presence of high platelet-fibrin clot strength (MA ≥68 mm) and low fibrinolytic activity (LY30 < 0.2%) was synergistically associated with MACE occurrence. In the multivariable analysis, the combined phenotype of 'MA ≥ 68 mm' and 'LY30 < 0.2%' was a major predictor of post-PCI MACE in the AMI group [adjusted hazard ratio (HR): 1.744; 95% CI: 1.135-2.679; P = 0.011], but not in the non-AMI group (adjusted HR: 1.031; 95% CI: 0.499-2.129; P = 0.935). CONCLUSION: AMI occurrence is significantly associated with hypercoagulability and impaired fibrinolysis. Their combined phenotype increases the risk of post-PCI atherothrombotic event only in AMI patients. These observations may support individualized therapy that targets thrombogenicity for better outcomes in patients with AMI. CLINICAL TRIAL REGISTRATION: Gyeongsang National University Hospital (G-NUH) Registry, NCT04650529. | en |
dc.format.extent | 11 | |
dc.format.extent | 6660847 | |
dc.language.iso | eng | |
dc.relation.ispartof | European Heart Journal | |
dc.subject | acute myocardial infarction | |
dc.subject | atherothrombosis | |
dc.subject | fibrinolysis | |
dc.subject | hypercoagulability | |
dc.subject | Cardiology and Cardiovascular Medicine | |
dc.title | Prognostic impact of hypercoagulability and impaired fibrinolysis in acute myocardial infarction | en |
dc.contributor.institution | Centre for Health Services and Clinical Research | |
dc.contributor.institution | Basic and Clinical Science Unit | |
dc.contributor.institution | Department of Clinical, Pharmaceutical and Biological Science | |
dc.contributor.institution | School of Life and Medical Sciences | |
dc.description.status | Peer reviewed | |
dc.date.embargoedUntil | 2024-05-14 | |
dc.identifier.url | http://www.scopus.com/inward/record.url?scp=85159741534&partnerID=8YFLogxK | |
rioxxterms.versionofrecord | 10.1093/eurheartj/ehad088 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |