Document Detail


Possible role of vascular intima for generation of coagulant activity in patients undergoing coronary thrombolysis with recombinant tissue-type plasminogen activator. A randomized, placebo-controlled study.
MedLine Citation:
PMID:  1810018     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In our present placebo-controlled study on recombinant tissue-type plasminogen activator (rt-PA) and heparin treatment of patients with acute ischaemic heart disease (IHD), we studied the extent of fibrin resolution and generation of coagulant activity. In rt-PA treated patients the lysis of fibrin in vivo (median 60 nmol of fibrin--estimated as fibrinogen equivalents) was significantly higher (p less than 0.02) than can be accounted for solely by lysis of a coronary thrombus (approximately 2 nmol) and circulating soluble fibrin (median 15 nmol). We observed a 200% increase of plasma concentrations of both prothrombin fragment 1 + 2 (p less than 0.001) and thrombin-antithrombin III complexes (p less than 0.001) as a consequence of rt-PA treatment, indicating that the coagulant activity is primarily caused by a physiological activation of the coagulation system. We conclude that an important contribution to the activation of coagulation in patients undergoing coronary thrombolysis is lysis of fibrin deposited widespread on the vascular intima, and that this process causes an intimal-dependent activation of the coagulation system.
Authors:
S Munkvad; J Gram; J Jespersen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of clinical and laboratory investigation     Volume:  51     ISSN:  0036-5513     ISO Abbreviation:  Scand. J. Clin. Lab. Invest.     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1992-05-27     Completed Date:  1992-05-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0404375     Medline TA:  Scand J Clin Lab Invest     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  581-90     Citation Subset:  IM    
Affiliation:
Department of Clinical Chemistry, Ribe County Hospital, Esbjerg, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Amino Acid Sequence
Blood Coagulation / physiology*
Coronary Disease / drug therapy*,  physiopathology
Coronary Vessels / physiopathology*
Double-Blind Method
Heparin / therapeutic use*
Humans
Middle Aged
Molecular Sequence Data
Recombinant Proteins / therapeutic use
Tissue Plasminogen Activator / therapeutic use*
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 9005-49-6/Heparin; 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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