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Impaired Fibrinolysis Predicts Adverse Outcome in Acute Coronary Syndrome Patients with Diabetes : A PLATO Sub-Study

Sumaya, Wael (författare)
Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England.
Wallentin, Lars, 1943- (författare)
Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
James, Stefan, 1964- (författare)
Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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Siegbahn, Agneta, 1947- (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi
Gabrysch, Katja (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
Himmelmann, Anders (författare)
AstraZeneca Res & Dev, Gothenburg, Sweden.
Ajjan, Ramzi A. (författare)
Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, England.
Storey, Robert F. (författare)
Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England.
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Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England Kardiologi (creator_code:org_t)
2020-01-23
2020
Engelska.
Ingår i: Thrombosis and Haemostasis. - : GEORG THIEME VERLAG KG. - 0340-6245 .- 2567-689X. ; 120:3, s. 412-422
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Hypofibrinolysis is a key abnormality in diabetes but the role of impaired clot lysis in predicting vascular events and mortality in this population is yet to be determined. We aimed to investigate the relationship between fibrin clot properties and clinical outcomes in patients with diabetes and recent acute coronary syndrome (ACS). Plasma samples were collected at hospital discharge from 974 ACS patients with diabetes randomised to clopidogrel or ticagrelor in the PLATO trial. A validated turbidimetric assay was employed to study fibrin clot lysis and maximum turbidity. One-year rates of cardiovascular (CV) death, spontaneous myocardial infarction (MI) and PLATO-defined major bleeding events were assessed after sample collection. Hazard ratios (HRs) were determined using Cox proportional analysis. After adjusting for CV risk factors, each 50% increase in lysis time was associated with increased risk of CV death/MI (HR 1.21; 95% confidence interval [CI] 1.02-1.44; p = 0.026) and CV death alone (HR 1.38; 1.08-1.76; p = 0.01). Similarly, each 50% increase in maximum turbidity was associated with increased risk of CV death/MI (HR 1.25; 1.02-1.53; p = 0.031) and CV death alone (HR 1.49; 1.08-2.04; p = 0.014). The relationship between lysis time and the combined outcome of CV death and MI remained significant after adjusting for multiple prognostic vascular biomarkers ( p = 0.034). Neither lysis time nor maximum turbidity was associated with major bleeding events. Impaired fibrin clot lysis predicts 1-year CV death and MI in diabetes patients following ACS.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

acute coronary syndrome
diabetes
fibrinolysis

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

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