低纤维蛋白溶解是最近公认的ST段抬高型心肌梗死(STEMI)患者复发性心血管事件的危险因素。但是这方面的机械决定因素还没有得到很好的理解。在STEMI患者中,我们表明,全血中内源性纤维蛋白溶解的有效性部分取决于纤维蛋白原水平,高敏C反应蛋白,和剪切诱导的血小板反应性,后者与凝血酶生成的速度直接相关。我们的发现加强了细胞成分的作用以及凝血和炎症途径之间的双向串扰作为低纤维蛋白溶解决定因素的证据。
Hypofibrinolysis is a recently-recognized risk factor for recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI), but the mechanistic determinants of this are not well understood. In patients with STEMI, we show that the effectiveness of endogenous fibrinolysis in whole blood is determined in part by fibrinogen level, high sensitivity C-reactive protein, and shear-induced platelet reactivity, the latter directly related to the speed of thrombin generation. Our findings strengthen the evidence for the role of cellular components and bidirectional crosstalk between coagulatory and inflammatory pathways as determinants of hypofibrinolysis.