Effects of direct percutaneous transluminal coronary angioplasty treatment of acute myocardial infarction on plasma levels of haemostatic and fibrinolytic factors.
Although thrombolytic therapy is used widely for treatment of acute myocardial infarction (AMI), thrombolysis itself increases thrombin activity and may cause reocclusion of infarct-related vessels. Direct percutaneous transluminal coronary angioplasty (PTCA) is an effective treatment for AMI; however, it is not clear what effects PTCA has on coagulation and fibrinolysis. We investigated coagulation and fibrinolytic factor concentrations before and after direct PTCA. Plasma levels of thrombin-antithrombin III complex (TAT), D-dimer, plasmin-(alpha 2-antiplasmin complex (PAP), tissue-type plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI)-1 antigen were followed in twelve patients treated with direct PTCA for AMI. Before PTCA, only TAT concentrations were significantly elevated compared to normal controls. D-dimer, TAT, PAP and PAI-1 concentrations were similar before and after PTCA. Eleven patients had no recurrent ischaemia and no restenosis on follow-up coronary angiography. These data confirm that direct PTCA is less likely than thrombolysis to affect coagulation and fibrinolysis.
Saito
M
M
Third Department of Internal Medicine, Kanazawa University School of Medicine, Japan.
Nakabayashi
T
T
Iuchi
K
K
Ishikawa
T
T
Kaseno
K
K
Yoshida
T
T
Asakura
H
H
Matsuda
T
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000933:Antifibrinolytic Agents; D000990:Antithrombin III / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000378:metabolism*; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D007700:Kinetics; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy*; D010447:Peptide Hydrolases / Q000378:metabolism; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator; D005341:Fibrinolysin