[Assessment of hemostasis in patients with myocardial infarction complicated by deep venous thrombosis]
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K Lewandowski1, P Psuja, M Zozulińska
1Kliniki Hematologii, AM im. K. Marcinkowskiego w Poznaniu.
Insights
Early diagnosis of deep vein thrombosis in acute myocardial infarction patients is challenging. Standard blood clotting and fibrinolysis tests show limited usefulness for detecting thrombotic complications.
Area of Science:
- Cardiology
- Hematology
- Thrombosis Research
Context:
- Acute myocardial infarction (AMI) patients are at risk for venous thromboembolism.
- Understanding coagulation and fibrinolysis changes post-AMI is crucial for risk stratification.
- Limited data exists on the utility of routine hemostasis tests for predicting thrombosis in AMI.
Purpose:
- To investigate changes in blood clotting and fibrinolysis markers in AMI patients.
- To assess the predictive value of these markers for deep vein thrombosis (DVT) development.
- To evaluate the diagnostic utility of standard tests for DVT in AMI.
Summary:
- A study of 53 AMI patients monitored for 14 days identified specific coagulation and fibrinolysis alterations in those who developed DVT.
- On day 1, shortened kaolin-cephalin clotting time and elevated fibrin degradation products (FDP) were observed in DVT patients.
- On day 14, elevated fibrinogen and reduced exogenous fibrinolytic activity correlated with DVT, while other markers remained unchanged.
Impact:
- Findings suggest standard coagulation and fibrinolysis tests have limited value for early DVT detection in AMI.
- Highlights the need for improved diagnostic tools for thrombotic risk assessment in AMI patients.
- Informs clinical practice regarding the interpretation of hemostasis parameters in the context of myocardial infarction and thrombosis.
Abstract:
The study was carried out of 53 patients with acute myocardial infarction receiving no anticoagulant treatment. Changes were traced in certain indices of the blood clotting system and fibrinolysis in plasma in the first 14 days of the disease, with particular attention given to patients in whom during the hospitalization signs of deep vein thrombosis in the lower extremities appeared or a positive result was obtained of the test with 125I-fibrinogen. In a group of 9 patients with deep vein thrombosis developing during the observation, on the first day of myocardial infarction shortening of the kaolin-cephalin clotting time and considerable rise of the level of fibrinogen-fibrin (FDP) degradation products were noted in serum, and on the 14th day raised fibrinogen level and reduced exogenous fibrinolytic activity of the plasma were noted. Increased level of fibrinogen and FDP and exogenous and endogenous plasma fibrinolytic activity observed on the 7th day of the disease were not related to the development of thrombotic complications. The thrombin clotting time, platelet count, factor X level, protein C concentration and antithrombin III activity in the plasma were not significantly changed during myocardial infarction. The obtained results suggest a limited usefulness of the basic tests of the clotting and fibrinolytic systems for early diagnosis of deep vein thrombosis in acute myocardial infarction.