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Thromb Haemost 1992; 68(06): 678-682
DOI: 10.1055/s-0038-1646343
Original Article
Schattauer GmbH Stuttgart

Von Willebrand Factor, Plasminogen Activator Inhibitor-1 and C-Reactive Protein Are Markers of Thrombolytic Efficacy in Acute Myocardial Infarction

F Andreotti
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
,
D R Hackett
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
,
A W Haider
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
,
M C Roncaglioni
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
,
G J Davies
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
,
J L Beacham
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
,
C Kluft
2   The Gaubius Laboratory, IVVO-TNO, Leiden, The Netherlands
,
A Maseri
1   The Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
› Author Affiliations
Further Information

Publication History

Received 01 June 1992

Accepted 31 July 1992

Publication Date:
24 July 2018 (online)

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Summary

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 24 h and daily up to 72 h. A continuous electrocardiogram was recorded in the first 24 h. Coronary arteriography was performed 90 min and 24 h 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 24 h (p = 0.001), a greater fall in plasminogen activator inhibitor from 24 to 48 h (p = 0.04) and a fall in C-reactive protein from 48 to 72 h (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.

 

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