Key result
Elevated FPA and PAI activity in ACS indicate increased coronary thrombosis and fibrinolysis resistance.
Why the study?
The pathophysiology of acute coronary syndrome involves coronary artery thrombosis driven by enhanced coagulation and reduced fibrinolysis, but detailed dynamic phase mechanisms remain to be clarified.
Acute coronary syndrome is characterized by a dual pathophysiological mechanism of enhanced coagulation (indicated by elevated FPA) and impaired fibrinolysis (indicated by elevated PAI activity), leading to persistent coronary thrombosis.
Acute coronary syndromeの病態の主体は冠動脈血栓である.血栓形成には,血液凝固系の亢進および線溶系の低下が必要である.血液凝固系よりの検討では,生体内thrombin生成のもっとも鋭敏な指標であるfibrinopeptide A (FPA)を用い,また線溶系からの検討では,線溶能を決定するより重要な要素であり, tissue-plasminogen activator (t-PA)の阻害物質であるplasminogen activator inhibitor (PAI)を指標として検討を行った.その結果, acute coronary syndromeにおいては, FPAの上昇よりthrombin生成ひいては冠動脈血栓形成が生じ易くなる一方,生じた血栓はPAI活性の上昇により溶解しにくい状態となることが示唆された.
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久雄 et al. (1995) conducted a review in Acute coronary syndrome. Coagulation and fibrinolysis markers (FPA and PAI) was evaluated. In acute coronary syndrome, elevated fibrinopeptide A indicates increased thrombin generation leading to coronary thrombosis, while elevated plasminogen activator inhibitor activity makes the thrombus resistant to fibrinolysis.
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