Myocardial troponin T release is associated with enhanced fibrinolysis in patients with acute coronary syndromes

Patients with acute coronary syndromes (ACS) frequently present with signs of disturbed fibrinolysis. The present study investigates the correlation o f alterations in the fibrinolytic system and the amount of myocardial damag e characterized by troponin release. In 85 patients with ACS markers of plasmin activation, plasminogen activato r system and troponin T (TnT) were measured initially and after 48 h, Patie nts with TnT release ( greater than or equal to 0.01 mug/l) at admission ha d higher TPA levels than those without release (10.2 +/- 0.7 ng/ml vs. 7.6 +/- 0.5 ng/ml; p <0.01). Additionally, patients with positive TnT had highe r D-dimer levels initially (457 +/- 39 ng/ml vs. 316 +/- 22 ng/ml; p <0.01) and 48 h later (451 +/- 42 ng/ml vs. 275 +/- 37 ng/ml; p <0.01). The assoc iation of myocardial damage with a prothrombotic state and an enhanced fibr inolysis may explain the high prognostic value of troponin measurements in respect to future coronary events.