Systemic lytic state is not a predictor of coronary reperfusion in acute myocardial infarction

International Journal of Cardiology
N el GaylaniM B Buchalter

Abstract

To investigate why approximately one third of patients thrombolysed with streptokinase fail to reperfuse, we assessed the lytic status, antistreptokinase antibody and non invasive parameters of reperfusion in 95 consecutive patients with acute myocardial infarction treated with streptokinase for the first time. The lytic status was assessed by Clauss fibrinogen assay and thrombin clotting time before and 2 h after streptokinase infusion. Antistreptokinase antibody was measured prior to the infusion. Reperfusion was assessed by measurement of the 24:96 h troponin-T ratio (a ratio > 1 indicating reperfusion) and ST segment resolution 2 h post streptokinase. Ninety-two (97%) patients achieved a systemic lytic state with a fibrinogen titre of less than 1.0 g/l and thrombin clotting time ratio of > 2.5. Despite this, 27% failed to reperfuse with a mean 24:96 h troponin-T of 0.9, SD 0.6 vs. 3.4 +/- 3.2 in the reperfused group, (P < 0.0001). 83% of the reperfused group but none of the non reperfused group had ST segment resolution. No difference was observed in the levels of fibrinogen and thrombin clotting time between the reperfused 0.25 +/- 0.3 g/l; 6.9 +/- 4, and the non reperfused group 0.4 +/- 0.6 g/l; 7.9 +/- 2.6. No difference...Continue Reading

References

Dec 5, 1991·The American Journal of Cardiology·C R Conti
Dec 1, 1989·Journal of Molecular and Cellular Cardiology·H A KatusW Kübler
Feb 19, 1966·British Medical Journal·M VerstraeteC Vermylen
Jul 1, 1984·Journal of the American College of Cardiology·A S LewW Ganz
Jun 1, 1994·Clinical and Experimental Immunology·M LynchR A Stockley
Aug 1, 1993·British Heart Journal·M B Buchalter
Dec 1, 1993·British Heart Journal·H S LeeK Jennings

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Citations

Jun 27, 1998·Lancet·C H Davies, O J Ormerod
Mar 26, 2002·International Journal of Cardiology·Khawar A KazmiNaseema Mehboobali
Oct 20, 2012·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Mojgan BandehpourBahram Kazemi
Sep 6, 2005·Thrombosis Research·Chetan Varma, Gregory Y H Lip
Dec 31, 1997·Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates·J A Ragsdale

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