[Changes in hemocoagulation during thrombolytic therapy of acute myocardial infarct in relation to risks of thrombotic complications].
In 38 patients with acute myocardial infarction treated with 1.5 million u. of streptokinase hemocoagulation parameters were assessed before and after treatment and after another 12, 24 and 48 hours. The authors revealed three risk indicators of thrombotic complications: 1. a shortened aPTT before treatment and at the same time a less than double prolongation of aPTT, as compared with control plasma after treatment (P < 0.01, sensitivity 0.67, specificity 0.81). 2. A non-detectable fibrinogen level (less than 1.1 milligrams) 24 hours after termination of treatment (P < 0.05, sensitivity 0.59, specificity 0.71). 3. The third risk factor 3 is a combination of the previous two: shortened aPTT before treatment and at the same time its inadequate prolongation after treatment and/or an undetectable fibrinogen level 24 hours after treatment (P < 0.001, sensitivity 1.00, specificity 0.57). In all the authors' patients with thrombotic complications (reinfarction, recurrent myocardial ischaemia, extended infarction, intracardiac thrombosis, embolization into the CNS) this 3rd combined risk factor was positive.
Kessler
P
P
II. interní oddĕlení nemocnice, Jihlava.
Kubícková
M
M
D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D010314:Partial Thromboplastin Time; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013927:Thrombosis / Q000097:blood / Q000209:etiology*
D005340:Fibrinogen
Zmĕny hemokoagulace pri trombolytické lécbĕ akutního infarktu myokardu ve vztahu k riziku trombotických komplikací.