{"id":"b08f0f9717a4","type":"article","url":"https://hartvaat.nl/2018/04/01/fibrinestoleigenschappen-en-klinische-uitkomsten-na-acs-plato-substudie/","title":"Fibrinestoleigenschappen en klinische uitkomsten na ACS: PLATO-substudie","title_en":"Fibrin clot properties independently predict adverse clinical outcome following acute coronary syndrome: a PLATO substudy.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["abelacimab","trombose"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehy013","source_url":"https://doi.org/10.1093/eurheartj/ehy013","authors":["Wael Sumaya","Lars Wallentin","Stefan K James","Agneta Siegbahn","Katja Gabrysch","Maria Bertilsson","Anders Himmelmann","Ramzi A Ajjan","Robert F Storey"],"significance":5,"published":"2018-04-01","source_date":"2018-04-01","image":"","kennis":[],"congress":"","summary_en":"This PLATO substudy showed that fibrin clot properties independently predict adverse clinical outcomes after ACS, identifying a novel thrombotic biomarker beyond traditional platelet and coagulation measures.","created":"2026-07-03T10:27:13Z","updated":"2026-07-03T13:26:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"PLATO substudie die aantoont dat fibrinestoleigenschappen onafhankelijk de klinische uitkomsten voorspellen na ACS. Nieuwe biomarker voor de coagulatietoestand.","abstract_original":"AIMS: To determine whether fibrin clot properties are associated with clinical outcomes following acute coronary syndrome (ACS). METHODS AND RESULTS: Plasma samples were collected at hospital discharge from 4354 ACS patients randomized to clopidogrel or ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial. A validated turbidimetric assay was employed to study plasma clot lysis time and maximum turbidity (a measure of clot density). One-year rates of cardiovascular (CV) death, spontaneous myocardial infarction (MI) and PLATO-defined major bleeding events were assessed after sample collection. Hazard ratios (HRs) were estimated using Cox proportional hazards models. After adjusting for CV risk factors, each 50% increase in lysis time was associated with CV death/spontaneous MI [HR 1.17, 95% confidence interval (CI) 1.05-1.31; P < 0.01] and CV death alone (HR 1.36, 95% CI 1.17-1.59; P < 0.001). Similarly, each 50% increase in maximum turbidity was associated with increased risk of CV death (HR 1.24, 95% CI 1.03-1.50; P = 0.024). After adjustment for other prognostic biomarkers (leukocyte count, high-sensitivity C-reactive protein, high-sensitivity troponin T, cystatin C, N-terminal pro B-type natriuretic peptide, and growth differentiation factor-15), the association with CV death remained significant for lysis time (HR 1.2, 95% CI 1.01-1.42; P = 0.042) but not for maximum turbidity. These associations were consistent regardless of randomized antiplatelet treatment (all interaction P > 0.05). Neither lysis time nor maximum turbidity was associated with major bleeding events. CONCLUSION: Fibrin clots that are resistant to lysis independently predict adverse outcome in ACS patients. Novel therapies targeting fibrin clot properties might be a new avenue for improving prognosis in patients with ACS."}