ORIGINAL ARTICLESThe effect of chronic kidney disease on fibrin clot properties in patients with acute coronary syndromeUndas, Anettaa; Nycz, Krzysztofa; Pastuszczak, Macieja; Stompor, Tomaszb; Zmudka, KrzysztofaAuthor Information aInstitute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland bDepartment of Nephrology, University Hospital, Olsztyn, Poland Received 23 January, 2010 Revised 20 March, 2010 Accepted 26 March, 2010 Correspondence to Anetta Undas, Institute of Cardiology, Jagiellonian University School of Medicine, 80 Prądnicka Street, 31-202 Krakow, Poland Tel: +48 126143004; e-mail: email@example.com Blood Coagulation & Fibrinolysis: September 2010 - Volume 21 - Issue 6 - p 522-527 doi: 10.1097/MBC.0b013e32833a9035 Buy Metrics Abstract Chronic kidney disease (CKD), defined as a decreased estimated glomerular filtration rate (eGFR < 60 ml/min), is an independent risk factor for cardiovascular events. Both acute coronary syndrome (ACS) and end-stage renal disease have been shown to be associated with formation of compact fibrin clots relatively resistant to lysis. The aim of the current study was to evaluate the effect of CKD on fibrin clot properties in patients with ACS. In 30 ACS patients, aged 48–72 years, with CKD and 30 ACS patients with eGFR more than 60 ml/min, we investigated plasma fibrin clot properties using permeation and turbidity assays, including three different clot lysis assays. The ACS patients with eGFR less than 60 ml/min and those with normal filtration rate did not differ with regard to demographics, risk factors, medications and routine laboratory tests, including fibrinogen. The former group had higher plasminogen activator inhibitor-1 (P = 0.002) and tissue-type plasminogen activator (tPA) (P = 0.008). Compared with ACS patients with eGFR more than 60 ml/min, the ACS patients with CKD formed less porous fibrin clots (P = 0.004) and susceptible to fibrinolysis (P < 0.001), had thicker overall fibrin fibers (P = 0.007), earlier onset of fibrin clot formation (P = 0.004) and increased clot mass (P < 0.001). By multiple regression analysis, clot permeability was independently predicted by eGFR (P = 0.0005) and fibrinogen (P = 0.001), whereas the only predictors of lysis time were eGFR (P = 0.006) and tPA (P = 0.002). This study indicates that ACS patients with CKD display unfavorable fibrin clot properties including impaired fibrinolysis, which might contribute to worse outcome in this population. © 2010 Lippincott Williams & Wilkins, Inc.