Several prospective studies in healthy and diseased individuals have explored the relationship of coagulation and fibrinolysis factor levels in plasma to the incidence and recurrence of arterial occlusive events. In particular, fibrinogen, tissue-type plasminogen activator antigen and plasminogen activator inhibitor 1 concentrations have been shown to correlate positively to the risk of myocardial infarction or stroke. Recent investigations focus on potential causal mechanisms underlying such risk associations. These include the impact of fibrinogen levels on clot network structures as well as the role of fibrinogen and altered expression of fibrinolytic vessel wall components in the development and progression of atherosclerotic lesions. Finally, markers of coagulation and fibrinolysis activation, such as prothrombin fragments 1+2, fibrino-peptide A, thrombin-antithrombin III complex and D-dimer, have been used to study intracardiac clotting in patients with mitral valve disease and atrial fibrillation. Yet, their relevance in predicting the risk of cardiac thrombus formation and cerebral embolization remains to be determined.

Keywords:
Stroke, Cerebral embolism, Myocardial infarction, Atrial fibrillation, Fibrinogen, Fibrinolysis, Prothrombin fragments, D-Dimer, Fibrinopeptides
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© 1995 S. Karger AG, Basel
1995
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