Detection of hypofibrinolysis in stable coronary artery disease using the overall haemostatic potential assay

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Caroline J Reddel1, Jennifer L Curnow, Jasmin Voitl

  • 1ANZAC Research Institute, University of Sydney, Australia.

Thrombosis Research
|April 16, 2013
PubMed

Insights

Stable coronary artery disease patients show increased blood clotting and reduced clot breakdown. The overall haemostatic potential (OHP) assay may help identify hypercoagulability for better risk stratification.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Patients with stable coronary artery disease (CAD) face risks of arterial thrombosis and myocardial infarction.
  • Identifying hypercoagulability and hypofibrinolysis is crucial for risk stratification and personalized treatment in CAD.
  • This study investigated global hemostatic potential and thrombin generation in stable CAD patients.

Purpose of the Study:

  • To examine overall haemostatic potential (OHP) and thrombin generation in stable CAD patients.
  • To investigate associations between fibrinolytic inhibitors and abnormal global fibrinolysis.
  • To assess the utility of the OHP assay for identifying hypercoagulability.

Main Methods:

  • Blood samples from 56 stable CAD patients and healthy controls were analyzed.
  • Global coagulation assays included overall haemostatic potential (OHP) and thrombin generation (calibrated automated thrombogram, CAT).
  • Platelet aggregometry and plasminogen activator inhibitor-1 (PAI-1) antigen levels were measured.

Main Results:

  • Stable CAD patients exhibited increased thrombin generation and impaired fibrinolysis (reduced overall fibrinolytic potential, OFP, and prolonged clot lysis time) compared to controls.
  • Medications did not significantly affect these parameters in platelet-poor plasma.
  • PAI-1 emerged as a key determinant of OFP in CAD patients, unlike in healthy individuals where fibrinogen was significant.

Conclusions:

  • Stable CAD is characterized by plasma hypercoagulability, driven by enhanced thrombin generation and diminished fibrinolytic potential.
  • The overall haemostatic potential (OHP) assay offers a straightforward method for identifying individual patient hypercoagulability.
  • Findings highlight the contribution of both procoagulant and hypofibrinolytic states to CAD pathophysiology.
Abstract

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