| Importance of thrombosis and thrombolysis in silent ischaemia: comparison of patients with acute myocardial infarction and unstable angina. | |
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MedLine Citation:
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PMID: 8130023 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate whether plaque rupture and thrombosis have a role in silent ischaemia as well as in unstable angina. DESIGN: Prospective analysis of the results of haemostatic diagnostic tests at the moment of developing silent ischaemia at rest. SETTING: Coronary care unit. PATIENTS: 22 patients with acute myocardial infarction, 12 patients with symptomatic angina (unstable angina), and 10 normal volunteers (control group). INTERVENTIONS: Continuous cardiac monitoring detected 15 asymptomatic episodes (silent ischaemia) in 6 patients with unstable angina. Blood samples were obtained at admission and when an asymptomatic alteration was detected and 10 minutes later. MAIN OUTCOME MEASURES: Comparisons of concentrations of tissue plasminogen activator, urokinase type plasminogen activator, tissue plasminogen activator inhibitor-1, cross-linked fibrin degradation products, von Willebrand factor, and thrombin-antithrombin III complexes in patients and controls at admission; same comparisons in patients with silent ischaemia at the start of an episode and 10 minutes later. RESULTS: Tissue plasminogen activator concentrations were raised at admission in patients with acute myocardial infarction (mean (SD) 14.2 (6) ng/ml) and in patients with unstable angina (10.1 (2.5) ng/ml) in comparison with controls (5.1 (2.7) ng/ml, p < 0.01 and < 0.05 respectively). There was no differences between the two groups of patients, however. Similar results were observed at the start of a silent ischaemic episode (9.8 (1.9) ng/ml) and 10 minutes later (10.5 (2.9) ng/ml) compared with controls (p < 0.05). Tissue plasminogen activator inhibitor-1 concentrations were raised in patients with acute myocardial infarction (45.1 (15) ng/ml) compared with volunteers (20.6 (16) ng/ml, p < 0.01). In patients with silent ischaemia tissue plasminogen activator inhibitor-1 concentrations were slightly but not significantly increased. Concentrations of cross-linked fibrin degradation products (D dimer) increased during unstable angina (2150 (350) ng/ml) and silent ischaemia (2270 (450) ng/ml) compared with the concentrations in volunteers (340 (80) ng/ml) and patients with acute myocardial infarction (310 (120) ng/ml; p < 0.01). CONCLUSIONS: The results suggest that thrombosis mediates the pathophysiological mechanisms of silent ischaemia and unstable angina. |
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Authors:
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E Gurfinkel; R Altman; A Scazziota; J Rouvier; B Mautner |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: British heart journal Volume: 71 ISSN: 0007-0769 ISO Abbreviation: Br Heart J Publication Date: 1994 Feb |
Date Detail:
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Created Date: 1994-04-15 Completed Date: 1994-04-15 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0370634 Medline TA: Br Heart J Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 151-5 Citation Subset: AIM; IM |
Affiliation:
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Centro de Estudios Medicos y Bioquimicos, Buenos Aires, Argentina. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina, Unstable
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blood,
etiology* Electrocardiography, Ambulatory Female Fibrinolysis / physiology Humans Male Middle Aged Myocardial Infarction / blood, etiology* Myocardial Ischemia / blood, diagnosis, etiology* Plasminogen Activator Inhibitor 1 / blood Prospective Studies Thrombosis / blood, complications* Tissue Plasminogen Activator / blood |
| Chemical | |
Reg. No./Substance:
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0/Plasminogen Activator Inhibitor 1; EC 3.4.21.68/Tissue Plasminogen Activator |
| Comments/Corrections | |
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