Increased plasma concentration of fibrin monomer in acute myocardial infarction with early reperfusion.
OBJECTIVE
To assess whether plasma fibrin monomer (FM) concentration, a marker of thrombin activity, is increased in the first hours after acute coronary occlusion and whether there are differences between patients with and without early reperfusion.


METHODS
Thirty-five consecutive patients with acute myocardial infarction (AMI) and early coronary angiography were studied prospectively.


METHODS
Plasma FM samples taken on admission (< 6 h after onset of chest pain) and 6-14 h after onset of chest pain were analysed using a specific enzyme immunoassay. All of the patients were anticoagulated with heparin intravenously.


RESULTS
Of the 35 patients, 28 had angiographically documented reperfusion within the first 6 h, whereas seven patients had no early reperfusion. FM concentrations were measured in the reference range (< or = 3.6 mg/l) within the first 6 h in 32 of the 35 patients. At 6-14 h FM concentrations were elevated in the reperfusion group (median 4.56 mg/l), but not in the group without reperfusion (median 1.6 mg/l, P = 0.0063). Using a threshold value of 3.0 mg/l, sensitivity and specificity of FM for the non-invasive recognition of early reperfusion were 78 and 83%, respectively. The specificity was similar to that for troponin T and higher than the creatinine kinase MB specificity.


CONCLUSIONS
FM plasma concentrations are elevated in patients with AMI and early reperfusion. With a single blood sample 6-14 h after onset of chest pain, FM analysis is useful for the non-invasive detection of early reperfusion after AMI.
Spiecker
M
M
Second Medical Clinic, Johannes Gutenberg University of Mainz, Germany.
Hafner
G
G
Nixdorff
U
U
Prellwitz
W
W
Meyer
J
J
D000925:Anticoagulants / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000187:drug effects / Q000378:metabolism*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007124:Immunoenzyme Techniques; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015425:Myocardial Reperfusion; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood; D020107:Troponin T
D000925:Anticoagulants; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D014336:Troponin; D020107:Troponin T; C011468:fibrinmonomer; D006493:Heparin; D003402:Creatine Kinase