Course of indicators of thrombin activity in the early phase of acute myocardial infarction: effect of fibrinolytic therapy and acute percutaneous coronary angioplasty.
We evaluated assay systems for detection of in vivo thrombin activity in patients with acute myocardial infarction. The study included 31 consecutive patients with acute myocardial infarction treated either with fibrinolytic therapy (FLT), or acute PTCA. Blood samples were drawn at admission, after 30 min, 1 h, 3 h, 6 h, 12 h, 24, and 48 h. Assays related to the enzymatic action of thrombin included fibrinopeptide A ELISA, a novel latex-enhanced photometric immunoassay for soluble fibrin complexes, fibrin monomer antigen, D-dimer antigen, and soluble platelet glycoprotein V, which is released from the platelet surface by thrombin cleavage. The soluble fibrin assay displayed a high degree of correlation with fibrinopeptide A, and no correlation with D-dimer antigen, indicating that this parameter allows monitoring of in vivo thrombin activity in patients with acute myocardial infarction. Fibrin monomer antigen, and D-dimer antigen, were influenced by FLT, indicating cross-reactivity with proteolytic fragments of fibrin. No significant changes in soluble glycoprotein V were observed. The results show that the novel soluble fibrin assay appears to be a promising method for measurement of in vivo fibrin formation in patients with acute myocardial infarction, irrespective of the primary treatment decision for FLT or acute PTCA.
Dempfle
Carl-Erik
CE
University Hospital of Mannheim, I Department of Medicine, Mannheim, Germany. carl-erik.dempfle@med.ma.uni-heidelberg.de
Kaden
Jens J
JJ
Haase
Karl K
KK
Borggrefe
Martin
M
D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005337:Fibrin / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005344:Fibrinopeptide A / Q000032:analysis; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000628:therapy; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000032:analysis; D012995:Solubility; D013917:Thrombin / Q000032:analysis*; D013997:Time Factors
D015415:Biomarkers; D002317:Cardiovascular Agents; D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; D019038:Platelet Glycoprotein GPIb-IX Complex; C036309:fibrin fragment D; D005344:Fibrinopeptide A; D005337:Fibrin; D013917:Thrombin