PMID: 2117619Sep 1, 1990Paper

Role of thrombolysis and thrombin in patients with acute coronary occlusion during percutaneous transluminal coronary angioplasty

Journal of the American College of Cardiology
D C GulbaP R Lichtlen

Abstract

In a series of 447 patients with single vessel angioplasty, 27 (6.0%) had acute thrombotic occlusion early after the procedure. They were treated with combined intracoronary (20 mg)/intravenous (50 mg) thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) and repeat mild balloon inflations. Reopening of the vessel was achieved in 22 patients (81.5%). Follow-up coronary angiography 24 to 36 h later revealed reocclusion in 12 patients (54.5%). Thrombin levels measured as thrombin-antithrombin-III complex in patients with successful thrombolysis and persistent patency decreased from 8.5 +/- 11.4 micrograms/liter at baseline to 3.5 +/- 1.4 micrograms/liter 120 min after the start of thrombolysis; these levels increased from 9.4 +/- 15.0 micrograms/liter at baseline to 15.7 +/- 13.5 micrograms/liter 120 min after the start of thrombolysis in the patients with unsuccessful thrombolysis or early reocclusion (p less than 0.05). When a borderline value for thrombin-antithrombin-III complex level of 6 micrograms/liter was selected to separate the two groups of patients, patients with an unfavorable clinical course were identified 120 min after the start of thrombolysis by levels greater than 6 micrograms/liter (sensitiv...Continue Reading

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Citations

Jun 11, 1992·Journal of the American College of Cardiology·J J PopmaG O Hartzler
Nov 1, 1994·Journal of the American College of Cardiology·P T Vaitkus, W K Laskey
Dec 1, 1995·Journal of the American College of Cardiology·H J RupprechtJ Meyer
Oct 22, 1998·The American Journal of Cardiology·T MurakamiM Ohnaka
Jul 1, 1995·Progress in Cardiovascular Diseases·L Schwartz, P H Seidelin
Nov 5, 1997·American Heart Journal·B A BergelsonC L Tommaso
Jun 1, 1992·Chest·A J Tiefenbrunn
Dec 1, 1993·Arteriosclerosis and Thrombosis : a Journal of Vascular Biology·R LassilaV Manninen
May 1, 1997·Catheterization and Cardiovascular Diagnosis·A ChauhanI M Penn

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