Coagulation activation and long-term outcome in acute coronary syndromes

Diego Ardissino, Piera Angelica Merlini, Kenneth A. Bauer, Marcello Galvani, Filippo Ottani, Franca Franchi, Federico Bertocchi, Robert D. Rosenberg, Pier Mannuccio Mannucci

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

After an episode of unstable angina or myocardial infarction, a high proportion of patients show biochemical signs of coagulation activation, expressed as persistently elevated thrombin generation, in their blood. It is not known whether this has any influence on long-term outcome. In this prospective multicenter cohort study, we assessed the relation of persistently elevated thrombin generation to outcome in 319 consecutive patients with acute coronary syndromes enrolled in the Global Use of Strategies To Open occluded coronary arteries (GUSTO) IIb trial. Plasma prothrombin fragment 1 + 2 levels, an index of "in vivo" thrombin generation, was measured during the acute phase and after 1, 6, and 12 months, and its relation to outcome was assessed during a median 29-month follow-up period. The primary end point of cardiac death or myocardial (re)infarction occurred in 61 patients (19%). There was a U-shaped relationship between plasma prothrombin fragment 1 + 2 levels and the risk of developing the primary end point; intermediate levels (1.5-1.9 nM) were associated with the lowest risk, whereas both higher (> 1.9 nM) and lower (<1.5 nM) values were associated with an increased risk (relative risk [RR] 1.56 and 95% confidence interval [Cl], 1.25-2.28; RR, 1.35 and 95% Cl, 1.11-1.86, respectively). After an episode of acute coronary syndrome, both high and low levels of thrombin generation are predictors of an increased risk of an unfavorable outcome.

Original languageEnglish
Pages (from-to)2731-2735
Number of pages5
JournalBlood
Volume102
Issue number8
DOIs
Publication statusPublished - Oct 15 2003

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Acute Coronary Syndrome
Coagulation
Chemical activation
Thrombin
Myocardial Infarction
Plasmas
Unstable Angina
Multicenter Studies
Coronary Vessels
Blood
Cohort Studies
Confidence Intervals

ASJC Scopus subject areas

  • Hematology

Cite this

Ardissino, D., Merlini, P. A., Bauer, K. A., Galvani, M., Ottani, F., Franchi, F., ... Mannucci, P. M. (2003). Coagulation activation and long-term outcome in acute coronary syndromes. Blood, 102(8), 2731-2735. https://doi.org/10.1182/blood-2002-03-0954

Coagulation activation and long-term outcome in acute coronary syndromes. / Ardissino, Diego; Merlini, Piera Angelica; Bauer, Kenneth A.; Galvani, Marcello; Ottani, Filippo; Franchi, Franca; Bertocchi, Federico; Rosenberg, Robert D.; Mannucci, Pier Mannuccio.

In: Blood, Vol. 102, No. 8, 15.10.2003, p. 2731-2735.

Research output: Contribution to journalArticle

Ardissino, D, Merlini, PA, Bauer, KA, Galvani, M, Ottani, F, Franchi, F, Bertocchi, F, Rosenberg, RD & Mannucci, PM 2003, 'Coagulation activation and long-term outcome in acute coronary syndromes', Blood, vol. 102, no. 8, pp. 2731-2735. https://doi.org/10.1182/blood-2002-03-0954
Ardissino D, Merlini PA, Bauer KA, Galvani M, Ottani F, Franchi F et al. Coagulation activation and long-term outcome in acute coronary syndromes. Blood. 2003 Oct 15;102(8):2731-2735. https://doi.org/10.1182/blood-2002-03-0954
Ardissino, Diego ; Merlini, Piera Angelica ; Bauer, Kenneth A. ; Galvani, Marcello ; Ottani, Filippo ; Franchi, Franca ; Bertocchi, Federico ; Rosenberg, Robert D. ; Mannucci, Pier Mannuccio. / Coagulation activation and long-term outcome in acute coronary syndromes. In: Blood. 2003 ; Vol. 102, No. 8. pp. 2731-2735.
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