title: Von Willebrand factor, plasminogen activator inhibitor-1 and C-reactive protein are markers of thrombolytic efficacy in acute myocardial infarction.
abstract: Plasma von Willebrand factor, plasminogen activator inhibitor activity and C-reactive protein were assessed as markers of coronary recanalisation in 30 patients with acute myocardial infarction receiving tissue-type plasminogen activator (t-PA). Blood samples were taken before t-PA (time 0), 4-hourly for 24 h and daily up to 72 h. A continuous electrocardiogram was recorded in the first 24 h. Coronary arteriography was performed 90 min and 24 h after the start of t-PA. Patients with a patent infarct artery (n = 17), compared to those with occluded artery (n = 13), showed a fall in von Willebrand factor from 0 to 24 h (p = 0.001), a greater fall in plasminogen activator inhibitor from 24 to 48 h (p = 0.04) and a fall in C-reactive protein from 48 to 72 h (p = 0.002). The accuracy of these indices compared favourably with time to peak plasma MB creatine kinase and > or = 50% resolution of maximal ST-deviation on the electrocardiogram. Thus, changes in plasma von Willebrand factor, plasminogen activator inhibitor and C-reactive protein during the first 3 days of myocardial infarction are indicative of thrombolytic efficacy. Their concordant behaviour may reflect a common regulatory mechanism.
authors.affiliation: Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
authors.forename: F
authors.initials: F
authors.lastname: Andreotti
authors.forename: D R
authors.initials: DR
authors.lastname: Hackett
authors.forename: A W
authors.initials: AW
authors.lastname: Haider
authors.forename: M C
authors.initials: MC
authors.lastname: Roncaglioni
authors.forename: G J
authors.initials: GJ
authors.lastname: Davies
authors.forename: J L
authors.initials: JL
authors.lastname: Beacham
authors.forename: C
authors.initials: C
authors.lastname: Kluft
authors.forename: A
authors.initials: A
authors.lastname: Maseri
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D017395:Plasminogen Activator Inhibitor 1; D014841:von Willebrand Factor; D002097:C-Reactive Protein; D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator