Author + information
- Received June 4, 1990
- Revision received September 17, 1990
- Accepted September 28, 1990
- Published online March 15, 1991.
- Steffen Munkvad, MD∗,a,
- Jørgen Jespersen, MD, Dsca,
- Jørgen Gram, MD, DSca and
- Cornelis Kluft, MSc, DSc∗,a
- ↵∗Address for reprints: Steffen Munkvad, MD, Section of Coagulation and Fibrinolysis, Department of Clinical Chemistry, Ribe County Hospital in Esbjerg, 6700 Esbjerg, Denmark.
In a randomized placebo-controlled study, seven patients with acute myocardial infarction allocated to intravenous treatment with 100 mg of recombinant tissue-type plasminogen activator (rt-PA) and seven patients allocated to placebo were studied during eight sampling periods before and after treatment. Seven patients with acute myocardial infarction treated intravenously with 1.5 million U of streptokinase were later studied during two sampling periods before and after treatment. The placebo group showed no significant deviations of endogenous factor XII-dependent fibrinolytic activity (p > 0.05). In the rt-PA group, this activity decreased significantly (p < 0.001) after the infusion and remained depressed throughout the 1st 4 days. A significant decrease in activity (p < 0.05) was also found in the streptokinase-treated patients.
The depletion of factor XII-dependent fibrinolytic activity was not due to generation of inhibition or a depletion of factor XII, prekallikrein and plasminogen, but could be related to the proactivator of this system. It is concluded that rt-PA (and streptokinase) treatment in patients with acute myocardial infarction causes a prolonged depletion of factor XII-dependent fibrinolytic activity. This depression of endogenous fibrinolytic activity needs to be evaluated in relation to the enhanced risk of coronary reocclusion after thrombolytic therapy.
☆ This study was supported in part by a grant from the Danish Heart Foundation (Hjerte-foreningen) and by Boehringer Ingelheim, International GmbH, Ingelheim am Rhein, Federal Republic of Germany.
- Received June 4, 1990.
- Revision received September 17, 1990.
- Accepted September 28, 1990.