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Supplemental Material, Revised_Supplementary_File_FINAL for Markers of Thrombin Generation Are Associated With Long-Term Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction by Charlotte Holst Hansen, Vibeke Ritschel, Geir Øystein Andersen, Sigrun Halvorsen, Jan Eritsland, Harald Arnesen, and Ingebjørg Seljeflot in Clinical and Applied Thrombosis/Hemostasis

In this thesis we studied patients with acute ST- elevation myocardial infarction and their relation to different circulating biomarkers reflecting activation of the inflammatory and haemostatic system and a marker associated with ischemia/reperfusion injury and remodelling. We found that a novel inflammatory marker, soluble IL-6 receptor (sIL-6R) was associated with increased risk of future cardiovascular events including new myocardial infarction, readmission for heart failure, stroke or all-cause mortality. IL-6 and C-reactive protein as well as markers of hypercoagulability were associated with larger infarcts and reduced left ventricular function. CCN2, a marker of remodelling was not related with either infarct size, left ventricular function or increased risk of new adverse events, indicating that the soluble form of this protein does not play an important role in this setting. The main conclusion is that higher levels of sIL-6R in the sub-acute phase after a STEMI are associated with adverse prognosis. Inhibition of the IL-6 receptor may be a therapeutic approach.

Introduction Platelet activation, thrombin generation and fibrin formation play important roles in intracoronary thrombus formation, which may lead to acute myocardial infarction. We investigated whether the prothrombotic markers D-dimer, pro-thrombin fragment 1 + 2 (F1 + 2) and endogenous thrombin potential (ETP) are associated with myocardial necrosis assessed by Troponin T (TnT), and left ventricular impairment assessed by left ventricular ejection fraction (LVEF) and N-terminal pro b-type natriuretic peptide (NT-proBNP). Materials/Methods Patients (n = 987) with ST-elevation mycardial infarction (STEMI) were included. Blood samples were drawn at a median time of 24 h after onset of symptoms. Results Statistically significant correlations were found between both peak TnT and D-dimer (p