[Markers for the prognosis of success of coronary interventions: focus on changes in fibrinolysis and hemostasis].

BACKGROUND

The morphology of the culprit coronary lesion is a most important factor for the prognosis of a percutaneous coronary intervention in patients with acute coronary syndrome. The most widely accepted grading of the complexity of the coronary stenosis is the modified ACC/AHA grading (from A to C).

DISTURBANCES OF FIBRINOLYTIC SYSTEM: Further alterations like a hypercoagulative state and a disturbed fibrinolytic system are known in patients with unstable angina pectoris. In these patients a close correlation was observed between the complexity of stenosis morphology and the disturbances in the fibrinolytic system judged as measurement of the tissue-type plasminogen activator mass concentration or as measurement of the activity of the plasminogen activator inhibitor (PAI-1). For markers of thrombin activation no close correlation to the morphological grading was found.

CONCLUSION

It should be investigated in further studies whether markers of the fibrinolytic system might be useful for assessment of the prognosis of a coronary intervention in patients with acute coronary syndrome.