| Early coronary reperfusion blunts the procoagulant response of plasminogen activator inhibitor-1 and von Willebrand factor in acute myocardial infarction. | |
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MedLine Citation:
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PMID: 2123906 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effects of early coronary recanalization on the plasma levels of two procoagulant acute phase proteins, the fastacting plasminogen activator inhibitor and von Willebrand factor, were investigated in 24 patients with myocardial infarction receiving intravenous recombinant tissue-type plasminogen activator (rt-PA) within 6 h of the onset of symptoms. Coronary angiography was performed before and 90 min after the start of rt-PA infusion. Continuous electrocardiographic recordings and 4 h plasma creatine kinase MB isoenzyme (CK MB) were performed over the first 24 h. Plasma plasminogen activator inhibitor activity, von Willebrand factor and C-reactive protein were measured before rt-PA infusion, daily for the first 3 days and after 90 days. In the entire group, plasminogen activator inhibitor activity peaked at 24 h (day 1), representing a significant increase over values at all other times (p = 0.03). von Willebrand factor was higher in the first 2 days of infarction compared with after 90 days (p = 0.001). C-reactive protein peaked on day 2, with an eightfold increase over values on admission (p = 0.001). In the 16 patients with a patent infarct-related artery at 90 min, infarct size estimated by integrated 24 h CK MB, time for ST segment elevation to decrease to half-maximum and peak C-reactive protein were reduced significantly by more than twofold compared with values in the 8 patients with an occluded artery at 90 min. The patients with early recanalization also had lower plasminogen activator inhibitor activity on day 2 (p = 0.05) and day 3 (p = 0.02) and lower 0 to 72 h averaged von Willebrand factor (p = 0.01). Thus, early coronary recanalization curtails the response of plasminogen activator inhibitor activity and von Willebrand factor to myocardial infarction, most likely by reducing the extent of ischemia and necrosis and the consequent acute phase reaction. By blunting the early postinfarction procoagulant state, prompt recanalization may reduce the risk of thromboembolic complications in the first days after myocardial infarction. |
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Authors:
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F Andreotti; M C Roncaglioni; D R Hackett; M I Khan; T Regan; A W Haider; G J Davies; C Kluft; A Maseri |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 16 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1990 Dec |
Date Detail:
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Created Date: 1991-01-24 Completed Date: 1991-01-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1553-60 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Research Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, England. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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C-Reactive Protein
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analysis Coronary Vessels / physiopathology Creatine Kinase / blood Female Humans Isoenzymes Male Middle Aged Myocardial Infarction / blood, drug therapy* Myocardial Reperfusion* Plasminogen Inactivators / analysis* Time Factors Tissue Plasminogen Activator / therapeutic use* Vascular Patency / physiology von Willebrand Factor / analysis* |
| Chemical | |
Reg. No./Substance:
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0/Isoenzymes; 0/Plasminogen Inactivators; 0/von Willebrand Factor; 9007-41-4/C-Reactive Protein; EC 2.7.3.2/Creatine Kinase; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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