The measurement of fibrinogen by the DuPont aca and Dade methods in patients receiving streptokinase infusions.
To assess the discrepancies noted in fibrinogen measurement by the DuPont aca and Dade methods, nine patients receiving streptokinase (SK) by either the intracoronary (IC) (240,000 IU/60 minutes) (two patients) or intravenous (IV) (1,500,000 IU/45 minutes) routes (seven patients) for acute myocardial infarctions were studied over 48-72 hours. All nine patients showed a rapid and profound fall in fibrinogen to unrecordable levels (30 mg/dL) by the Dade method. Three patients showed a similar response to unrecordable levels (less than 50 mg/dL) with the DuPont aca method. Six others had less of a decrease with the DuPont aca method compared with the Dade method. One patient showed a gradual fall by the DuPont aca method to reach 60% of the preinfusion level at 30 hours, whereas the minimal value by the Dade method, 81% of the preinfusion level, was reached within 12 hours. There was no difference in fibrinogen levels by the Dade method after absorption of heparin-like activity with triethylamino ethyl (TEAE) cellulose. Fibrinogen degradation products (FDPs) were elevated in all patients post-SK infusion. These studies show that fibrinogen estimation by DuPont aca and Dade methods may yield discrepant results in approximately 66% of patients treated with SK. This may have some clinical relevance to clinicians who rely on the DuPont aca fibrinogen estimation to monitor effectiveness of SK therapy.
D003331:Coronary Vessels; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D007275:Injections, Intravenous; D008722:Methods; D009203:Myocardial Infarction / Q000188:drug therapy; D013300:Streptokinase / Q000008:administration & dosage* / Q000627:therapeutic use
D005338:Fibrin Fibrinogen Degradation Products; D005340:Fibrinogen; D013300:Streptokinase