Persistent thrombin generation during heparin therapy in patients with acute coronary syndromes

Piera Angelica Merlini, Diego Ardissino, Kenneth A. Bauer, Luigi Oltrona, Antonio Pezzano, Biancamaria Bottasso, Robert D. Rosenberg, Pier Mannuccio Mannucci

Research output: Contribution to journalArticle

Abstract

Intravenous heparin, a fundamental therapy in the treatment of patients with acute coronary syndromes, acts by inhibiting thrombin and activated factors X, IX, XI, and XII. It has also been demonstrated that heparin reduces plasma fibrinopeptide A, a marker of thrombin activity, but it is unknown whether it decreases prothrombin fragment 1+2, an indirect marker of thrombin generation. We measured the plasma levels of prothrombin fragment 1+2, fibrinopeptide A, and antithrombin III in 64 consecutive patients with unstable angina or myocardial infarction receiving intravenous heparin. Blood samples were obtained at baseline (before any treatment) and then at 90 minutes and 24 and 48 hours after the administration of an intravenous bolus of heparin (5000 IU) followed by a continuous infusion of 1000 IU per hour to maintain activated partial thromboplastin time at more than double its baseline levels. In comparison with baseline, there was a significant decrease in fibrinopeptide A at 90 minutes and at 24 and 48 hours (baseline, 2.3 nmol/L; 90 minutes, 1.15 nmol/L; 24 hours, 1.4 nmol/L; 48 hours. 1.2 nmol/L; P

Original languageEnglish
Pages (from-to)1325-1330
Number of pages6
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume17
Issue number7
Publication statusPublished - 1997

Fingerprint

Fibrinopeptide A
Acute Coronary Syndrome
Thrombin
Heparin
Factor IXa
Factor Xa
Antithrombin III
Partial Thromboplastin Time
Unstable Angina
Therapeutics
Intravenous Administration
Myocardial Infarction
prothrombin fragment 2
prothrombin fragment 1

Keywords

  • Angina
  • Myocardial infarction
  • Thrombin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Persistent thrombin generation during heparin therapy in patients with acute coronary syndromes. / Merlini, Piera Angelica; Ardissino, Diego; Bauer, Kenneth A.; Oltrona, Luigi; Pezzano, Antonio; Bottasso, Biancamaria; Rosenberg, Robert D.; Mannucci, Pier Mannuccio.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 17, No. 7, 1997, p. 1325-1330.

Research output: Contribution to journalArticle

Merlini, PA, Ardissino, D, Bauer, KA, Oltrona, L, Pezzano, A, Bottasso, B, Rosenberg, RD & Mannucci, PM 1997, 'Persistent thrombin generation during heparin therapy in patients with acute coronary syndromes', Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 17, no. 7, pp. 1325-1330.
Merlini, Piera Angelica ; Ardissino, Diego ; Bauer, Kenneth A. ; Oltrona, Luigi ; Pezzano, Antonio ; Bottasso, Biancamaria ; Rosenberg, Robert D. ; Mannucci, Pier Mannuccio. / Persistent thrombin generation during heparin therapy in patients with acute coronary syndromes. In: Arteriosclerosis, Thrombosis, and Vascular Biology. 1997 ; Vol. 17, No. 7. pp. 1325-1330.
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