[Course and blood coagulation findings following systemic short-term fibrinolysis in acute myocardial infarct].
A series of 16 consecutive patients with acute myocardial infarction was investigated with respect to changes in coagulatory parameters after intravenous short-term treatment with 1,500 000 IU streptokinase (SK) over a period of 90 minutes. Samples for coagulation assays (fibrinogen, thrombin, time activated partial thromboplastin time (aPTT), normotest, thrombin-coagulase time, platelets, antithrombin III, plasminogen and antiplasmin activity, alpha 2-macroglobulin, alpha 1-antitrypsin, factor X a were collected before and immediately after iv SK, and after 4, 8, 12, 24, 36, 48 and 72 hours. Platelets, antithrombin III, factor X a, alpha 1-antitrypsin and alpha 2-macroglobulin showed no changes over the observed period. The concentrations of fibrinogen and the activities of plasminogen and antiplasmin decreased clearly during the first 24 hours, reaching a minimum immediately after SK administration. Thrombin time and aPTT were prolonged for 36 hours, with a maximum in the first hours after lysis.


CONCLUSIONS
Invasive diagnostic and/or therapeutic procedures during the first 24 hours after SK lysis should be carried out only for a definite, strict indication and under repeated control of the coagulatory status. After 24-36 hours there is a trend to normalisation of haemostasis. After 36 hours, surgery may be performed without fear of complications due to abnormal coagulability.
D001779:Blood Coagulation Factors / Q000032:analysis; D001780:Blood Coagulation Tests; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D013300:Streptokinase / Q000627:therapeutic use*
D001779:Blood Coagulation Factors; D013300:Streptokinase
Verlauf der Gerinnungsbefunde nach systemischer Kurzfibrinolyse beim akuten Myokardinfarkt.