Coronary artery disease (CAD) is the leading cause of death worldwide with acute myocardial infarction (MI) representing the clinical condition associated with the greatest morbidity and mortality, up to 30% of in-hospital deaths. Prompt reperfusion with percutaneous coronary intervention (PCI), advances in ...
Coronary artery disease (CAD) is the leading cause of death worldwide with acute myocardial infarction (MI) representing the clinical condition associated with the greatest morbidity and mortality, up to 30% of in-hospital deaths. Prompt reperfusion with percutaneous coronary intervention (PCI), advances in acute cardiovascular care and more effective medical therapy have improved the prognosis of patients with MI in the last years. This increased survival revealed a previously unrecognized short- and long-term risk of recurrent cardiovascular events despite optimal medical therapy. Indeed, almost one-fifth of MI patients suffer from rehospitalization within 1 year, and 10% from recurrent MI. There is, therefore, a growing need for a more accurate risk stratification of MI patients to identify those at higher risk for adverse events and worse prognosis. Current guidelines of the American Heart Association and the European Society of Cardiology highlighted the lack of useful biomarkers to predict in-hospital complications and short/long term prognosis of patients with MI, recommending for this purpose only to measure troponin and brain natriuretic peptide (BNP) serum levels, with the latter associated with a low level of evidence. During the last decades, several studies, mostly conducted in the 90s before the routine use of dual antiplatelet therapy, described the pivotal and prognostic role of coronary thrombosis and hypercoagulable state in the pathophysiology of MI, correlating increased inflammatory and coagulation activity with recurrent event and poor outcome after MI.
Despite many studies published, conclusive data on the real usefulness and additional value of biomarkers in the management of patients with MI are lacking. The aim of this article collection is to provide new evidence and summarize current evidence on the potential prognostic role of inflammatory and thrombotic biomarkers in patients with acute coronary syndrome.
Keywords:
biomarkers, myocardial infarction, thrombosis, thrombotic biomarkers, coronary artery disease
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