[Biological markers for acute phase hemostasis in coronary thrombosis]. / Les marqueurs biologiques de l'hémostase à la phase aiguë de la thrombose coronaire.

ABSTRACT

Associated with rheological conditions, multiple factors regarding haemostasis and fibrinolysis contribute to the instability and rupture of atherosclerotic plaque. Various biological parameters are modified during the occurrence of a coronary thrombotic episode, but do these increasingly identified alterations constitute a cause or a direct consequence of this accident? With the increasing identification of markers more and more sensitive but of limited specificity, the relative abundance of studies in the literature contrasts with the paucity of effective assets for everyday clinical practice. In fact, the potential use of these indicators in the evaluation of the pathogenesis of vascular accident, their eventual prognostic value, their predictive nature in therapeutic strategy, and their relevance for patient classification and follow up remain to be established on a wider scale. There is growing interest in the detection of evidence of cellular cooperation or a vascular compartment lesion thanks to the development of new diagnostic tools such as flux cytometry or immunoenzymology. While advances in biology have allowed undeniable clarifications of the physiopathology of coronary accidents and in the management of thrombotic pathology, it must nevertheless be endeavoured to give a practical response to the numerous questions where doubt remains, and to pursue the search for markers or tests clinically relevant.