Influence of heparin on fibrinogen and D-dimer plasma levels in acute myocardial infarction treated with streptokinase

A. Salvioni, G. C. Marenzi, P. Agostoni, S. Grazi, M. D. Guazzi

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Abstract

The purpose of this study was to investigate whether, to what extent, and through which mechanisms intravenous heparin, administered before and after streptokinase, affects the plasma levels of D-dimer and fibrinogen in myocardial infarction. Data concerning mortality and incidence of coronary recanalization in patients receiving heparin and thrombolytic therapy after acute myocardial infarction are controversial; furthermore, the mechanismns through which heparin acts in combination with thrombolytic therapy are unclear. Thirty-eight patients with acute myocardial infarction treated with streptokinase were considered. Nineteen of them received, immediately before the beginning of thrombolytic treatment, a bolus of heparin (100 U.kg-1 intravenously) and, 2 h later, intravenous heparin in doses raising the partial thromboplastin time to 2-2.5 times the normal value (Group 1); the remaining 19 did not receive anticoagulant treatment (Group 2). Multiple determinations of plasma D-dimer and fibrinogen levels were obtained in all patients before, and in the seven days following thrombolytic treatment. Six hours after streptokinase, fibrinogen decreased from 304 ± 34 to 61 ± 34 mg.dl-1 in Group 1 and from 312 ± 29 to 38 ± 21 mg.dl-1 in Group 2 (P-1 in Group 1 and 0.4 ± 0.1 μg.dl-1 in Group 2, increased at the 1st hour to 37.2 ± 36.5 μg.dl-1 and 52.2 ± 39.8 μg.dl-1 respectively. A peak value was reached in both groups at the 6th hour, which was followed by a slow decrease. A significant difference between the two groups (P

Original languageEnglish
Pages (from-to)654-659
Number of pages6
JournalEuropean Heart Journal
Volume15
Issue number5
Publication statusPublished - 1994

Fingerprint

Heparin
Acute Myocardial Infarction
Streptokinase
Dimer
Dimers
Fibrinogen
Plasma
Myocardial Infarction
Plasmas
Thrombolytic Therapy
Therapy
Partial Thromboplastin Time
Anticoagulants
Reference Values
Therapeutics
P-groups
Influence
fibrin fragment D
Acute myocardial infarction
Mortality

Keywords

  • D-dimer
  • Fibrinogen
  • Heparin
  • Myocardial infarction
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Physiology

Cite this

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title = "Influence of heparin on fibrinogen and D-dimer plasma levels in acute myocardial infarction treated with streptokinase",
abstract = "The purpose of this study was to investigate whether, to what extent, and through which mechanisms intravenous heparin, administered before and after streptokinase, affects the plasma levels of D-dimer and fibrinogen in myocardial infarction. Data concerning mortality and incidence of coronary recanalization in patients receiving heparin and thrombolytic therapy after acute myocardial infarction are controversial; furthermore, the mechanismns through which heparin acts in combination with thrombolytic therapy are unclear. Thirty-eight patients with acute myocardial infarction treated with streptokinase were considered. Nineteen of them received, immediately before the beginning of thrombolytic treatment, a bolus of heparin (100 U.kg-1 intravenously) and, 2 h later, intravenous heparin in doses raising the partial thromboplastin time to 2-2.5 times the normal value (Group 1); the remaining 19 did not receive anticoagulant treatment (Group 2). Multiple determinations of plasma D-dimer and fibrinogen levels were obtained in all patients before, and in the seven days following thrombolytic treatment. Six hours after streptokinase, fibrinogen decreased from 304 ± 34 to 61 ± 34 mg.dl-1 in Group 1 and from 312 ± 29 to 38 ± 21 mg.dl-1 in Group 2 (P-1 in Group 1 and 0.4 ± 0.1 μg.dl-1 in Group 2, increased at the 1st hour to 37.2 ± 36.5 μg.dl-1 and 52.2 ± 39.8 μg.dl-1 respectively. A peak value was reached in both groups at the 6th hour, which was followed by a slow decrease. A significant difference between the two groups (P",
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AU - Salvioni, A.

AU - Marenzi, G. C.

AU - Agostoni, P.

AU - Grazi, S.

AU - Guazzi, M. D.

PY - 1994

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N2 - The purpose of this study was to investigate whether, to what extent, and through which mechanisms intravenous heparin, administered before and after streptokinase, affects the plasma levels of D-dimer and fibrinogen in myocardial infarction. Data concerning mortality and incidence of coronary recanalization in patients receiving heparin and thrombolytic therapy after acute myocardial infarction are controversial; furthermore, the mechanismns through which heparin acts in combination with thrombolytic therapy are unclear. Thirty-eight patients with acute myocardial infarction treated with streptokinase were considered. Nineteen of them received, immediately before the beginning of thrombolytic treatment, a bolus of heparin (100 U.kg-1 intravenously) and, 2 h later, intravenous heparin in doses raising the partial thromboplastin time to 2-2.5 times the normal value (Group 1); the remaining 19 did not receive anticoagulant treatment (Group 2). Multiple determinations of plasma D-dimer and fibrinogen levels were obtained in all patients before, and in the seven days following thrombolytic treatment. Six hours after streptokinase, fibrinogen decreased from 304 ± 34 to 61 ± 34 mg.dl-1 in Group 1 and from 312 ± 29 to 38 ± 21 mg.dl-1 in Group 2 (P-1 in Group 1 and 0.4 ± 0.1 μg.dl-1 in Group 2, increased at the 1st hour to 37.2 ± 36.5 μg.dl-1 and 52.2 ± 39.8 μg.dl-1 respectively. A peak value was reached in both groups at the 6th hour, which was followed by a slow decrease. A significant difference between the two groups (P

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