Plasma von Willebrand factor, plasminogen activator inhibitor activity and C-reactive protein were assessed as markers of coronary recanalisation in 30 patients with acute myocardial infarction receiving tissue-type plasminogen activator (t-PA). Blood samples were taken before t-PA (time 0), 4-hourly for 24h and daily up to 72h. A continuous electrocardiogram was recorded in the first 24h. Coronary arteriography was performed 90 min and 24h after the start of t-PA. Patients with a patent infarct artery (n=17), compared to those with occluded artery (n=13), showed a fall in von Willebrand factor from 0 to 24h (p=0.001), a greater fall in plasminogen activator inhibitor from 24 to 48h (p=0.04) and a fall in C-reactive protein from 48 to 72h (p=0.002). The accuracy of these indices compared favourably with time to peak plasma MB creatine kinase and ≥50% resolution of maximal ST-deviation on the electrocardiogram. Thus, changes in plasma von Willebrand factor, plasminogen activator inhibitor and C-reactive protein during the first 3 days of myocardial infarction are indicative of thrombolytic efficacy. Their concordant behaviour may reflect a common regulatory mechanism.
|Number of pages||5|
|Journal||Thrombosis and Haemostasis|
|Publication status||Published - 1992|
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