6533b827fe1ef96bd1285b99

RESEARCH PRODUCT

Increased plasma concentration of fibrin monomer in acute myocardial infarction with early reperfusion.

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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. DESIGN 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.