| The effect of chronic kidney disease on fibrin clot properties in patients with acute coronary syndrome. | |
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MedLine Citation:
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PMID: 20479639 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Chronic kidney disease (CKD), defined as a decreased estimated glomerular filtration rate (eGFR < 60 ml/min), is an independent risk factor for cardiovascular events. Both acute coronary syndrome (ACS) and end-stage renal disease have been shown to be associated with formation of compact fibrin clots relatively resistant to lysis. The aim of the current study was to evaluate the effect of CKD on fibrin clot properties in patients with ACS. In 30 ACS patients, aged 48-72 years, with CKD and 30 ACS patients with eGFR more than 60 ml/min, we investigated plasma fibrin clot properties using permeation and turbidity assays, including three different clot lysis assays. The ACS patients with eGFR less than 60 ml/min and those with normal filtration rate did not differ with regard to demographics, risk factors, medications and routine laboratory tests, including fibrinogen. The former group had higher plasminogen activator inhibitor-1 (P = 0.002) and tissue-type plasminogen activator (tPA) (P = 0.008). Compared with ACS patients with eGFR more than 60 ml/min, the ACS patients with CKD formed less porous fibrin clots (P = 0.004) and susceptible to fibrinolysis (P < 0.001), had thicker overall fibrin fibers (P = 0.007), earlier onset of fibrin clot formation (P = 0.004) and increased clot mass (P < 0.001). By multiple regression analysis, clot permeability was independently predicted by eGFR (P = 0.0005) and fibrinogen (P = 0.001), whereas the only predictors of lysis time were eGFR (P = 0.006) and tPA (P = 0.002). This study indicates that ACS patients with CKD display unfavorable fibrin clot properties including impaired fibrinolysis, which might contribute to worse outcome in this population. |
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Authors:
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Anetta Undas; Krzysztof Nycz; Maciej Pastuszczak; Tomasz Stompor; Krzysztof Zmudka |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis Volume: 21 ISSN: 1473-5733 ISO Abbreviation: Blood Coagul. Fibrinolysis Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102551 Medline TA: Blood Coagul Fibrinolysis Country: England |
Other Details:
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Languages: eng Pagination: 522-7 Citation Subset: IM |
Affiliation:
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Institute of Cardiology, Jagiellonian University School of Medicine, 80 Pradnicka Street, Krakow, Poland. mmundas@cyf-kr.edu.pl |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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