Summary

Patients with acute coronary syndromes (ACS) frequently presentwith signs of disturbed fibrinolysis. The present study investigates thecorrelation of alterations in the fibrinolytic system and the amount ofmyocardial damage characterized by troponin release.In 85 patients with ACS markers of plasmin activation, plasminogenactivator system and troponin T (TnT) were measured initially andafter 48 h. Patients with TnT release (= 0.01 µg/l) at admission hadhigher 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 hadhigher 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 association of myocardial damage with a prothrombotic state andan enhanced fibrinolysis may explain the high prognostic value of troponinmeasurements in respect to future coronary events.