Gue Ying X, Jeong Young-Hoon, Farag Mohamed, Spinthakis Nikolaos, Gorog Diana A
Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK.
Department of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
J Clin Med. 2021 Mar 1;10(5):929. doi: 10.3390/jcm10050929.
Despite advancements in pharmacotherapy and interventional strategies, patients with acute coronary syndrome (ACS) remain at risk of recurrent thrombotic events. In addition to an enhanced tendency to thrombus formation, impairment in the ability to naturally dissolve or lyse a developing thrombus, namely impaired endogenous fibrinolysis, is responsible for a major part of this residual risk regardless of optimal antiplatelet medication. Global assessment of endogenous fibrinolysis, including a point-of-care assay, can identify patients with ACS at persistent high cardiovascular risk and might play an important role in allowing the personalisation of potent antithrombotic therapy to enhance fibrinolytic status, providing precision treatment of ACS to improve long-term outcome.
尽管药物治疗和介入策略取得了进展，但急性冠状动脉综合征（ACS）患者仍有复发性血栓事件的风险。除了血栓形成倾向增强外，自然溶解或溶解正在形成的血栓的能力受损，即内源性纤维蛋白溶解受损，无论抗血小板药物是否最佳，都是这种残余风险的主要原因。对内源性纤维蛋白溶解进行全面评估，包括即时检测，可识别出心血管风险持续较高的ACS患者，并可能在使强效抗血栓治疗个性化以增强纤维蛋白溶解状态、提供ACS精准治疗以改善长期预后方面发挥重要作用。
