title: Plasma soluble fibrin monomer complex as a marker of coronary thrombotic events in patients with acute myocardial infarction.
abstract: Soluble fibrin monomer appears in the bloodstream during the extremely early stage of blood coagulation and generally forms a complex with fibrinogen, termed soluble fibrin monomer complex (FMC). Determination of FMC can provide information regarding the state of thrombotic diseases; thus it is important to investigate whether FMC serves as an early indicator of myocardial infarction (MI). We investigated hemostatic and fibrinolytic parameters including FMC to determine their capabilities for indicating thrombotic conditions in the coronary artery. Blood samples from 47 patients with acute MI were obtained within 48 hours (acute phase) and during 120 - 600 hours (recovery phase), respectively, after MI onset. Plasma FMC was significantly elevated in the acute phase, compared with that during the recovery phase and in healthy controls (p = 0.001), suggesting that its elevation indicates thrombotic events in the coronary artery of MI patients. D-dimer, a marker of thrombus formation accompanied with fibrinolysis, was increased in both phases in the patients. In addition, FMC and D-dimer were significantly increased within 24 hours after onset as compared to 24 - 48 hours (p = 0.003 and p = 0.011). Furthermore, cardiac troponin T, a marker of myocardial damage, was significantly higher after 24 hours than within the first 24 hours (p = 0.001). Receiver operating characteristic (ROC) analysis of FMC for early MI diagnosis indicates that FMC, rather than D-dimer, is a better marker within 24 hours of onset. Measuring plasma FMC may be useful for early diagnosis of MI recurrence and deciding primary treatment.
authors.affiliation: Department of Internal Medicine, Health Sciences University of Hokkaido, Hokkaido, Japan. iekom@hoku-iryo-u.ac.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ieko
authors.forename: Sumiyoshi
authors.initials: S
authors.lastname: Naito
authors.forename: Mika
authors.initials: M
authors.lastname: Yoshida
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kanazawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mizukami
authors.forename: Harumi
authors.initials: H
authors.lastname: Sato
authors.forename: Tomoo
authors.initials: T
authors.lastname: Yui
authors.forename: Toru
authors.initials: T
authors.lastname: Nakabayashi
authors.forename: Takayuhi
authors.initials: T
authors.lastname: Hirabayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oguma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D003328:Coronary Thrombosis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis* / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D010447:Peptide Hydrolases / Q000097:blood; D012372:ROC Curve; D020107:Troponin T / Q000097:blood; D000511:alpha-Macroglobulins / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D020107:Troponin T; D000511:alpha-Macroglobulins; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C011468:fibrinmonomer; C024668:plasmin-alpha(2)-macroglobulin complex; D000990:Antithrombin III; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D010447:Peptide Hydrolases; D005341:Fibrinolysin