Background: 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.
Main body: 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.
Conclusion: 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.
Keywords: Acute myocardial infarction; Conventional coagulation tests; Thromboelastography; Thrombomodulin; Thrombotic molecules.
© 2026. The Author(s).