Abstract
The association of increasing serum levels of fibrinogen degradation products after recombinant tissue-type plasminogen activator (rt-PA) therapy with bleeding and early coronary patency was assessed in 242 patients with acute myocardial infarction. After administration of 5,000 IU heparin, a median of 40 mg (range 35 to 60) of double chain rt-PA was given intravenously in 90 min. Bleeding occurred in 62 patients; in 73% of patients it was observed within the 1st 24 h and 84% of events consisted of hematoma or prolonged bleeding, or both, at puncture sites. Bleeding events occurred 2.12 times as often in patients with serum levels of fibrinogen degradation products greater than 85 mg/liter as in patients with serum levels less than 22 mg/liter (95% confidence interval 1.01 to 4.43). The infarct-related coronary vessel was patent in 65% of patients at 90 min after the start of rt-PA infusion. In patients with high serum levels of fibrin(ogen) degradation products, coronary patency at 90 min after the start of rt-PA infusion was not better (13% less, 95% confidence interval - 33%, 13%) than in patients with low serum levels. This uncoupling of thrombolytic effect in terms of coronary patency and systemic fibrinogenolysis confirms...Continue Reading
References
Mar 1, 1986·Circulation·D CollenM Verstraete
Feb 1, 1989·Circulation·E J TopolK L Lee
Apr 13, 1985·Lancet·M VerstraeteJ Lubsen
Nov 2, 1985·Lancet·M VerstraeteD G Mathey
Jan 30, 1988·Lancet·M L SimoonsB Meier
Aug 6, 1988·Lancet·S Z GoldhaberD E Vaughan
Sep 3, 1988·Lancet·R G WilcoxJ R Hampton
Jul 15, 1986·Biochemistry·P Andrade-Gordon, S Strickland
Jun 15, 1986·Thrombosis Research·E P PâquesN Heimburger
Sep 1, 1986·Circulation·B CercekW Ganz
Jul 1, 1987·Circulation·J H ChesebroP Ludbrook
Aug 1, 1987·The American Journal of Cardiology·M VerstraeteJ Lubsen
Sep 1, 1987·Journal of the American College of Cardiology·H S MuellerS A Forman
Jan 1, 1988·Journal of the American College of Cardiology·A K RaoM L Terrin
Nov 26, 1988·BMJ : British Medical Journal·F Van de Werf, A E Arnold
Oct 22, 1987·The New England Journal of Medicine·D HackettA Maseri
Mar 1, 1985·Circulation·R L RothbardV J Marder
Sep 1, 1985·The American Journal of Cardiology·M W BurketT D Fraker
Dec 6, 1984·The New England Journal of Medicine·K P RentropH Meilman
Citations
Sep 1, 1992·Journal of the American College of Cardiology·J ArnoutM Verstraete
Aug 12, 1998·International Journal of Cardiology·R MeierhenrichU Tebbe
May 1, 1990·Journal of the American College of Cardiology·F W LeebeekA J Six
Aug 1, 1992·British Heart Journal·K RanjadayalanA D Timmis
Jul 1, 1999·Clinics in Chest Medicine·G S Francis
Feb 12, 2013·Expert Opinion on Biological Therapy·Bartlomiej Piechowski-Jozwiak, Julien Bogousslavsky
Sep 10, 2015·Ultrasound in Medicine & Biology·Florian C RoesslerJürgen Eggers
Apr 1, 1992·Chest·G Agnelli, P Parise
May 22, 2009·Expert Opinion on Biological Therapy·Maurizio PaciaroniJulien Bogousslavsky
Jan 15, 1991·Thrombosis Research·D P de BonoI Underwood
Jan 1, 1993·Toxicologic Pathology·S J Gardell
Jun 1, 1993·Angiology·L ChouhanJ C Pomposiello
Feb 1, 1992·Arteriosclerosis and Thrombosis : a Journal of Vascular Biology·M J MellottS J Gardell
Oct 1, 1994·Stroke; a Journal of Cerebral Circulation·G R ThomasW F Bennett
Sep 1, 1991·Circulation·J P BassandF Schiele
Mar 1, 1995·Circulation·M MontoneyV J Marder
Nov 15, 1995·Circulation·C R BenedictW F Bennett
Jul 1, 1991·Circulation·S J GardellG E Mark
Nov 15, 2003·Stroke; a Journal of Cerebral Circulation·Sophie GautierRégis Bordet
Oct 30, 2004·Stroke; a Journal of Cerebral Circulation·Askiel Bruno
Apr 24, 2004·Stroke; a Journal of Cerebral Circulation·Paul TrouillasMarc Dechavanne
Dec 4, 1992·Annals of the New York Academy of Sciences·R Fears
Oct 27, 1995·The Journal of Biological Chemistry·P BringmannP Donner
Jul 15, 1990·Thrombosis Research·S R TorrB E Sobel
Apr 1, 1990·Chest·M N LevineJ Hirsh
Mar 29, 2006·Biochemistry·Amy V L SchaeferJeffrey I Weitz