The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology最新文献

{"title":"Percutaneous closure of native and residual ventricular septal defects using a diverse range of occluder devices: a single-centre experience.","authors":"Ahmed R S A Afifi, Suhair Shebani, Gregory Skinner, Atul Kalantre, Marinos Kantzis","doi":"10.1186/s43044-026-00741-8","DOIUrl":"10.1186/s43044-026-00741-8","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter closure of ventricular septal defects (VSDs) presents technical challenges in patients with complex anatomies and residual post-surgical defects. This study aimed to evaluate the feasibility, safety, and early outcomes of percutaneous VSD closure using a range of occlusion devices in a heterogeneous patient population.</p><p><strong>Methods: </strong>This was a retrospective single-centre observational study of patients who underwent percutaneous VSD closure between 2017 and 2024 at a tertiary congenital cardiac centre.</p><p><strong>Results: </strong>Twenty patients were included (12 females, 8 males) with a median age of 5.5 years (range 6 months-72.9 years) and median body weight of 18 kg (range 6.4-127 kg). Native VSDs were present in 14 patients and residual post-surgical defects in 6. Defect types included perimembranous (n = 13; including 3 Gerbode defects) and muscular (n = 7). Procedural success was achieved in 95% (19/20). Immediate complete occlusion occurred in 65% (13/20), while 7 patients had small residual shunts that remained haemodynamically insignificant at 1-year follow-up. Complications included one case of transient haemolysis and one case of ventricular ectopy requiring surgical device retrieval. No cases of complete heart block, device embolisation, or significant valve injury were observed during follow-up.</p><p><strong>Conclusion: </strong>Percutaneous VSD closure using a range of occlusion devices is feasible and safe across different anatomies and age groups, with high procedural success and low complication rates at one-year follow-up.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacovigilance and clinical insights into perindopril-induced thrombocytopenia: a case report of diagnostic challenges and therapeutic alternatives.","authors":"Mochamad Faishal Riza, Samuel Sudanawidjaja, Ronald Torang Marsahala Panggabean, Isnaini Isnaini, Lely Puspita Candra Dewi, Andrianus Oktovianto, Deo Idarto, Vincent Aurelius Gonaldy, Alamanda Sofania, Marselina Marselina","doi":"10.1186/s43044-026-00737-4","DOIUrl":"10.1186/s43044-026-00737-4","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Perindopril-induced thrombocytopenia is a rare but potentially serious adverse drug reaction. It remains underrecognized in clinical practice, particularly in elderly patients with cardiovascular disease. This case highlights the importance of timely diagnosis and intervention in drug-induced hematologic complications.</p><p><strong>Case report: </strong>A 73-year-old woman with a history of percutaneous coronary intervention presented with unstable angina. During hospitalization, she exhibited an acute and unexplained decline in platelet count a week after the initiation of perindopril. Infectious causes, autoimmune disorders, and bone marrow dysfunction were systematically excluded. A medication review revealed recent perindopril initiation, and its discontinuation led to progressive platelet recovery. The strong temporal relationship confirmed perindopril-induced thrombocytopenia as the likely etiology (Table 1).</p><p><strong>Discussion: </strong>The immune-mediated destruction of platelets is proposed as the underlying mechanism, similar to other drug-induced thrombocytopenias. This case underscores the importance of systematic diagnostic evaluation, routine hematologic monitoring, and pharmacovigilance in patients receiving angiotensin-converting enzyme inhibitors. Alternative antihypertensive strategies, such as angiotensin receptor blockers, may be preferable in susceptible individuals.</p><p><strong>Conclusion: </strong>Perindopril-induced thrombocytopenia should be considered in patients presenting with unexplained platelet decline. Early recognition, drug discontinuation, and close monitoring are crucial in preventing complications. Further research is needed to refine diagnostic criteria and develop safer prescribing guidelines.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Gilbert syndrome on cardiovascular disease risk reduction: a systematic review.","authors":"Nicola Churchill, Luke Barry, Roch Nianogo","doi":"10.1186/s43044-026-00738-3","DOIUrl":"10.1186/s43044-026-00738-3","url":null,"abstract":"<p><strong>Background: </strong>Gilbert syndrome is a human genetic disorder which affects bilirubin metabolism in the liver and results in unconjugated hyperbilirubinemia. While considered a benign condition with only occasional jaundice and possible alterations of metabolism of certain drugs, Gilbert syndrome can reduce cardiovascular disease (CVD) risk. The objective of this review was to summarize the evidence on the potential effect of Gilbert Syndrome on reducing CVD risk via lowering cholesterol and/or lipid levels in the body and is associated with other protective mechanisms which are related to higher blood levels of unconjugated bilirubin.</p><p><strong>Methods: </strong>A systematic review of articles returned from the online database PubMed was conducted using search terms: \"Gilbert syndrome\", \"reduced cardiovascular disease risk\", \"cardiovascular disease\", \"cholesterol\", and \"lipid level\".</p><p><strong>Results: </strong>After filtering using the exclusion criteria and removing duplicates, eight articles were identified for the review. This review found that CVD risk was lower for people with Gilbert syndrome when compared to unaffected individuals. The reduced CVD risk was theorized to be due to elevated unconjugated bilirubin levels which lead to reduced concentrations of lipids, reduced inflammation biomarkers, decreased ABCA1 protein, increased serum antioxidant capacity expression, decreased BMI, and lower triglyceride levels.</p><p><strong>Conclusion: </strong>Individuals with Gilbert syndrome have a reduced CVD risk. Given that Gilbert syndrome reduces CVD risk in individuals and that Gilbert syndrome results in elevated serum levels of unconjugated bilirubin; elevation of unconjugated bilirubin could serve as a biomarker to monitor CVD risk reduction in the general population.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragmented QRS complex in athletes' electrocardiogram: physiological adaptation or pathological sign? A scoping review.","authors":"William Wiradinata, Faqrizal Ria Qhabibi","doi":"10.1186/s43044-026-00730-x","DOIUrl":"10.1186/s43044-026-00730-x","url":null,"abstract":"<p><strong>Background: </strong>Fragmented QRS (fQRS) complex, characterized by notching/slurring in the QRS complex, has been linked with myocardial fibrosis and sudden cardiac death (SCD) in cardiomyopathies. While fQRS is a recognized arrhythmogenic marker in hypertrophic cardiomyopathy, it is not included in the International Criteria for ECG interpretation in athletes.</p><p><strong>Methods: </strong>This review aims to evaluate the prevalence and clinical significance of fQRS in athletes. This review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guideline. A search was conducted across PubMed, ScienceDirect, and Google Scholar to identify relevant studies reporting fQRS in athletes across all age groups and sports discipline.</p><p><strong>Results: </strong>A total of 7 studies were included in the final review, revealing higher prevalence of fQRS in older age groups, with the highest prevalence occurring in lead V1. Athletes with fQRS also experienced no adverse events on follow-ups.</p><p><strong>Conclusions: </strong>Current data suggests that isolated fQRS, especially in lead V1, is likely benign. However, fQRS in ≥ 2 contiguous leads warrant further investigations. A longer follow-up duration is needed to ascertain the possibilities of adverse events occurring in athletes.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of ischemic stroke in Takotsubo cardiomyopathy patients: a systematic review and meta-analysis.","authors":"Aleyda Zahratunany Insanitaqwa, Maya Qurota A'yun, Faizah Nadlirah, Aulia Putri Fadriyana","doi":"10.1186/s43044-026-00736-5","DOIUrl":"10.1186/s43044-026-00736-5","url":null,"abstract":"<p><strong>Background: </strong>Takotsubo cardiomyopathy (TC) is a cardiomyopathy characterized by temporary ventricular dysfunction, often resembling myocardial infarction. The association between ischemic stroke and TC remains unclear, with unknown true incidence. The objective of this study is to assess the incidence of ischemic stroke in TC patients and its risk factors.</p><p><strong>Methods: </strong>We carried out a comprehensive search of PUBMED, Google Scholar, PROQUEST, and ScienceDirect databases from their inception to February 2026. Studies reporting the incidence of ischemic stroke in TC patients were included. The quality of studies was evaluated utilizing the Joanna Briggs Institute Critical Appraisal Tools. Statistical analyses were performed using Review Manager and RStudio.</p><p><strong>Results: </strong>This study included six studies with 35,573 participants (841 had ischemic stroke and 34,732 did not). The pooled incidence of ischemic stroke was 4% (95% CI 0.01-0.06; I² = 91%). The incidence of all-cause mortality was 36% (95% I 0.02-0.71, I² = 81%) in TC patients with ischemic stroke, significantly higher than the 3.12% (95%CI:0.01-0.05, I² = 37%) observed in TC patients without stroke. The mortality risk was higher in TC patients with ischemic stroke (OR7.57; 95% CI 2.70-21.22). Age (MD: 3.04; 95% CI 0.74-5.34), sex (OR0.64; 95% CI 0.53-0.77), diabetes (OR1.73; 95% CI 1.00-3.00), and atrial fibrillation (OR1.87; 95% CI 1.28-2.72) were significantly related to the incidence of ischemic stroke. However, smoking and hypertension showed no significant association with ischemic stroke.</p><p><strong>Conclusions: </strong>Ischemic stroke in TC patients correlates with an increased mortality rate and is associated with age, sex, and comorbidities, including diabetes and atrial fibrillation. Additional research is necessary to evaluate the possible advantages of anticoagulant therapy in TC patients.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myopericarditis in an emergency department patient presenting with chest pain and ECG changes: a case report.","authors":"Lauren Coaxum, Colleen McClean, Rebecca Theophanous","doi":"10.1186/s43044-026-00734-7","DOIUrl":"10.1186/s43044-026-00734-7","url":null,"abstract":"<p><strong>Background: </strong>Myopericarditis is uncommon but important to consider in patients presenting with chest pain. It most commonly is caused by a viral infection. Myopericarditis involves both myocardial injury and pericardial sac inflammation, thus may benefit from close monitoring and expedited treatment. It can present like pericarditis with chest pain, cold-type symptoms, diffuse ST elevations and PR depressions on electrocardiogram (ECG), and pericardial effusion on ultrasound. Risk stratification depends on case severity. More severe cases of myopericarditis can demonstrate elevated troponins and myocardial involvement, including potential left ventricular dysfunction.</p><p><strong>Case presentation: </strong>We describe an 81-year-old male patient with three days of pleuritic chest pain, dyspnea on exertion, and upper respiratory infection symptoms. He was evaluated by cardiology due to diffuse ST elevations on his ECG but did not have reciprocal changes, making acute coronary syndrome (ACS) less likely. His workup showed elevated inflammatory markers and elevated high-sensitivity troponin levels, indicating myocardial injury and distinguishing his diagnosis from pericarditis. His respiratory viral panel was negative. Bedside ultrasound showed a small pericardial effusion and moderately reduced ejection fraction (EF 40%). He was initiated on treatment for myopericarditis with colchicine and high-dose ASA (650 mg three times daily) for 3-4 weeks, with significant symptom improvement within 1-2 days.</p><p><strong>Conclusions: </strong>Emergency physicians should initiate early treatment for myopericarditis to reduce inflammation for improved patient outcomes while still considering ACS in all patients presenting with chest pain. Point-of-care ultrasound can identify a pericardial effusion or acute heart failure to guide management. Patients with myocardial involvement can develop permanent heart damage but can exhibit excellent recovery with appropriate treatment, which includes nonsteroidal anti-inflammatories, colchicine, and high-dose ASA.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent presentation of L-type ccTGA with pulmonary valve hypoplasia and RV dysfunction: from cardiogenic shock to surgical repair.","authors":"Shubham Jain, Deepak Kumar, Naween Kumar, Pankaj Mohan Shrivastava","doi":"10.1186/s43044-026-00733-8","DOIUrl":"10.1186/s43044-026-00733-8","url":null,"abstract":"<p><strong>Background: </strong>Congenitally corrected transposition of the great arteries (ccTGA) is an uncommon congenital heart defect involving both atrioventricular (AV) and ventriculoarterial (VA) discordance. This condition is further complicated by additional anomalies such as a hypoplastic pulmonary valve, ventricular septal defect (VSD), and dextroversion. These abnormalities may contribute to an increased risk of heart failure and cardiogenic shock, making early detection and appropriate intervention essential for better patient outcomes.</p><p><strong>Case presentation: </strong>A 16-year-old female presented with progressive shortness of breath, cyanosis, recurrent episodes of syncope, and exertional palpitations. Upon admission, the patient exhibited severe hypoxia, tachycardia, and hypotension, consistent with cardiogenic shock. She was NYHA grade IV at the time of presentation.Imaging studies, including chest X-ray and echocardiography, GLS- strain imaging and cardiac MRI confirmed the diagnosis of ccTGA with AV and VA discordance, a left-sided aortic arch, subaortic VSD, a hypoplastic pulmonary valve, and left sided morphologic right ventricular systolic dysfunction. Blood investigations indicated polycythemia and signs of congestive hepatopathy.</p><p><strong>Management and outcome: </strong>The patient was initially stabilized with inotropic support using norepinephrine (0.05-0.5 mcg/kg/min), along with diuretics and ACE inhibitors. Over the course of seven days, her condition improved significantly, allowing for the withdrawal of inotropic support. She was subsequently referred for surgical evaluation, with potential options including the double-switch procedure or VSD closure, depending on the extent of structural and functional abnormalities. Our patient underwent double switch procedure despite having RV dysfunction and improved significantly over a period of 3 months.</p><p><strong>Conclusion: </strong>This case underscores the significance of prompt recognition and aggressive management in complex congenital heart conditions like ccTGA. Cases of symptomatic ccTGA in adolescence are exceptionally rare, highlighting the importance of a multidisciplinary approach in optimizing patient care and surgical planning.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heparin protocols in cardiovascular surgery for antiphospholipid syndrome: a clinical case report.","authors":"Tomohiro Nakajima, Yutaka Iba, Tsuyoshi Shibata, Shuhei Miura, Takeko Hasegawa, Hidemichi Kouzu, Nobuyoshi Kawaharada","doi":"10.1186/s43044-026-00731-w","DOIUrl":"10.1186/s43044-026-00731-w","url":null,"abstract":"<p><strong>Background: </strong>Antiphospholipid syndrome (APS) is a prothrombotic disorder that presents significant challenges during cardiovascular surgery due to its high risk of both thrombotic and hemorrhagic complications. Perioperative management of anticoagulation, particularly with heparin, requires careful balancing to prevent catastrophic outcomes such as thromboembolism or excessive bleeding.</p><p><strong>Case presentation: </strong>The patient was a 66-year-old man. Two years prior, he was diagnosed with deep vein thrombosis (DVT), and direct oral anticoagulant (DOAC) therapy was initiated. Further evaluation in the cardiology department revealed elevated anticardiolipin antibody levels, leading to a diagnosis of APS. While on DOAC therapy, he was found to have severe aortic valve stenosis caused by a bicuspid aortic valve and 45-mm dilation of the ascending aorta. Surgical intervention was deemed necessary, and the operation was performed. As activated clotting time (ACT) tends to be elevated in APS, intraoperative heparin concentration was closely monitored. The surgery proceeded without perioperative embolic events, and the patient had an uneventful postoperative course.</p><p><strong>Conclusions: </strong>We report a case of open-heart surgery in a patient with APS, where perioperative embolic events were successfully avoided through close monitoring of blood heparin concentrations.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of type 1 aortic dissection with carotid arter occlusion, preoperative seizure, and postoperative spinal cord ischemia.","authors":"Mehmet Işık, Hanefi Furkan Öz, Hasan Hüseyin Kır, Yalçın Günerhan, Yüksel Dereli","doi":"10.1186/s43044-026-00732-9","DOIUrl":"10.1186/s43044-026-00732-9","url":null,"abstract":"<p><strong>Background: </strong>Aortic dissections are cardiovascular cases with high mortality that can present with many different clinical findings. The development of preoperative neurological findings may negatively affect postoperative results.</p><p><strong>Case presentation: </strong>In this case, a patient with a right common carotid artery occlusion due to type 1 aortic dissection, a plegic right lowers extremity, and a generalized tonic-clonic seizure just before surgery was presented. After the Bentall operation, spinal cord ischemia was diagnosed and pulse steroid treatment was started.</p><p><strong>Conclusions: </strong>The case was wanted to be shared due to its specific neurological and vascular condition.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four new markers of early thrombotic molecules and thromboelastography in prognostic evaluation of AMI patients undergoing PCI.","authors":"Weisha Sun, Yi Gao, Weiran Sun, Qinhan Zhang, Xi Zhao, Xuan Jing, Chonghua Hao","doi":"10.1186/s43044-026-00728-5","DOIUrl":"10.1186/s43044-026-00728-5","url":null,"abstract":"<p><strong>Background: </strong>Early and accurate diagnosis and prognostic evaluation of acute myocardial infarction (AMI) are essential to improve clinical outcomes. Conventional coagulation tests (CCTs) are routinely used but have limited sensitivity and specificity in capturing the complexity of thrombus formation and fibrinolysis.</p><p><strong>Main body: </strong>Recent research has introduced a range of emerging biomarkers-including thrombomodulin, thrombin-antithrombin complex, plasmin-α2-plasmin inhibitor complex, and tissue plasminogen activator inhibitor complex-that reflect endothelial injury, thrombin generation, and fibrinolytic activity. In parallel, thromboelastography (TEG) has gained attention as a whole-blood assay that offers a dynamic and comprehensive view of the coagulation cascade. These new tools provide valuable information beyond that available from traditional tests and have been explored for their diagnostic and prognostic utility in AMI patients undergoing percutaneous coronary intervention. The combined assessment of these biomarkers and TEG parameters enhances risk stratification by reflecting both vascular injury and coagulation dysfunction. Furthermore, TEG supports individualized antiplatelet therapy by continuously monitoring clot formation, strength, and dissolution.</p><p><strong>Conclusion: </strong>Based on the available evidence, we conclude that the biomarkers-TM, TAT, PIC, and t-PAIC-demonstrate potential clinical value in providing a more refined assessment of thrombus formation and fibrinolytic activity and TEG provides an important basis for optimizing antiplatelet therapy by dynamically monitoring the coagulation process in whole blood.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}