Key result
Troponin T elevation at admission is linked to ~34% higher TPA levels in ACS.
Why the study?
Patients with ACS frequently present with disturbed fibrinolysis, but the correlation between fibrinolytic alterations and myocardial damage characterized by troponin release was unclear.
Observational (n=85)
Absolute Event Rate: 10.2% vs 7.6%
p-value: p=<0.01
In patients with ACS, myocardial damage indicated by troponin T release is associated with a prothrombotic state and enhanced fibrinolysis.
Elevated admission TPA associates with TnT release in ACS; leaves open whether fibrinolytic markers aid risk stratification or warrant targeted intervention.
Patients with acute coronary syndromes (ACS) frequently present with signs of disturbed fibrinolysis. The present study investigates the correlation of alterations in the fibrinolytic system and the amount of myocardial damage characterized by troponin release. In 85 patients with ACS markers of plasmin activation, plasminogen activator system and troponin T (TnT) were measured initially and after 48 h. Patients with TnT release (> or = 0.01 microg/l) at admission had higher TPA levels than those without release (10.2+/-0.7 ng/ml vs. 7.6+/-0.5 ng/ml; p <0.01). Additionally, patients with positive TnT had higher D-dimer levels initially (457+/-39 ng/ml vs. 316+/-22 ng/ml; p <0.01) and 48 h later (451+/-42 ng/ml vs. 275+/-37 ng/ml; p <0.01). The association of myocardial damage with a prothrombotic state and an enhanced fibrinolysis may explain the high prognostic value of troponin measurements in respect to future coronary events.
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A 2001 study conducted an observational in Acute Coronary Syndromes (n=85). Troponin T release (≥ 0.01 µg/l) vs. No Troponin T release was evaluated on TPA levels at admission (p=<0.01). Troponin T release (≥0.01 µg/l) at admission in patients with acute coronary syndromes was associated with significantly higher TPA levels (10.2 vs 7.6 ng/ml; p<0.01) and D-dimer levels.
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