Altered fibrin clot properties and impaired fibrinolysis, such as denser clot structure and decreased permeability, contribute significantly to the thromboembolic risk and poor prognosis in patients with coronary artery disease.
Do altered fibrin clot properties and impaired fibrinolysis increase the risk of thromboembolic events and unfavorable outcomes in patients with coronary artery disease?
Altered fibrin clot properties and impaired fibrinolysis are significant contributors to thromboembolic risk in CAD patients and may serve as future prognostic biomarkers.
Despite improved diagnosis and treatment options, coronary artery disease (CAD) is still the leading cause of mortality and morbidity worldwide. Established risk factors such as smoking, hypercholesterolemia, and hypertension only partly explain the pathophysiology of CAD. Besides the well-known role of platelets in atherosclerosis and arterial thrombus formation, reduced endogenous fibrinolytic activity may play a key role in CAD formation and progression. Thus, biomarkers of fibrinolysis may be future CAD risk markers. In this review, we provide an overview of regulators of fibrinolysis and the main factors of importance to fibrin clot formation including coagulation factor XIII, thrombin, and fibrinogen. We summarize markers of altered fibrinolysis and current laboratory methods applied in clinical practice and research. We present today’s evidence on fibrin clot properties in patients with stable CAD or acute coronary syndrome compared with healthy individuals and the significance of altered fibrinolysis as a risk for coronary thrombotic disease. In conclusion, we found evidence that altered fibrin clot properties and impaired fibrinolysis appear to contribute significantly to the thromboembolic risk in CAD patients. Therefore, more research is crucial in order to clarify whether modulation of the fibrinolytic system may pave the way for improved treatment of CAD.
Larsen et al. (Fri,) conducted a review in Coronary artery disease (CAD). Altered fibrin clot properties and impaired fibrinolysis, such as denser clot structure and decreased permeability, contribute significantly to the thromboembolic risk and poor prognosis in patients with coronary artery disease.
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