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Fragmentation pattern of fibrinogen during thrombolysis in acute myocardial infarction with fibrin-specific plasmionogen activators — Detection of high molecular weight fibrinogen split products
POSTER PRESENTATIONS P-7: Thrombolytic Strategies
212
EFFFCTS OF CAPTOPRIL ON ENDOTHFL IN RELEASF DURING THROML3OLVSIS.PRELIMINARV RESULTS. Di Pasquale P,Paterna S,Parrinello G,Bucca V,CaraUSI K,Plpltone t.Licata ti. G.F.Ingrassia Hospital,Department Internal Medicine, University of PalermoJtaly. Aim of the study was to verify on the man if capto pril was able to reduce endothelin (EN) levels during thrombolysis(T) in acute myocardial infarction (AMI). pts hospitalised within 4 hs from the onset of symptoms. suitable for T(first episode),Killip randomised (double class I-2,all reperfused,were blind) into 2 Groups.Group 1: 15 pts (2F/l3M),mean age 58 ysreceived C 6.25 mg orally as first dose,15 min before T.Group Xplacebo) 12 pts (PF/lOM).mean age 64 ys,T only.Plasma levels of EN were checked before T,and at 1 and 2 hs,after T.Results:group 1 (5 unstable angina and 10 AMIs):before I 7.59+4.at 1 h 8.13+5.2 hs 9.99~7 pg/ml.Group 2 (control):(S UA and 7 AMIs) before T 7.41+4,1 h 7.09t5.2 hs 9.6146 only:Group 1 (IO AMIs) before -T pg/ml(p-ns).AMIs
213 Fragmentation
Pattern of Fibrinogen during Thrombolvsis in Acute Mvocardial Infarction with Fibrin-spe&ic plasmionogen activators - Detection of high molecular weight fibrinogen split products. H Thodel R. Dechend2, T. Miiller3, W.E. Eisert3, A, M. Barthelsl, D.C. Gulba2 Medizinische Hochschule Hannover (l), UKRV Franz-Volhard-Klinik, Free University Berlin (2), Dr. Karl Thomae GmbH, Biberach, Germany (3) In thrombolysis (T) in acute myocardial infarction (AMI), the fibrin specific plasminogen activators (PA) are infused in non physiologically high doses. Only limited fibrin-specific in nature, this may give rise to fibrinogen degradation (FgD). In a series of 75 patients (pts) - 24 rt-PA, 51 Pro-urokinase (PUK) we investigated, whether FgD follows a similar fragmentation pattern as known from T with streptokinase. During T, Fg levels (Ratnoff-Menzie) were stabel ( 3.2 f I,7 to 3.1 f 1.3 g/l/n.s.).
214
INTRAARTERIAL FIBRINOLYTIC PARAMETERS DURING LOCAL LOW DOSE STREPTOKINASE THERAPY. Kozak M, SaboviC M Trnovo Hospital of Internal Medicine, University Medical Centre, Ljubljana. Slovenia. Infroducfion: During local low dose intraarterial streptokinase thrombolysis some authors registereq a reduction in systemic (venous) plasminogen.(plg) and fibrinogen (fbg) concentrations. The aim of our study was to find out whether the degree of plg depletion is even more pronounced in the artery close to the thrombus. Patients and methods: 34 patients, treated with intraarterial streptokinase (3750 U/h) due to occlusive arterial disease of lower limbs, were included. The concentrations of pig. fbg and alfa-2 antiplasmin were measured in blood samples collected simultaneously from peripheral vein and from intraarterial catheter before drug administration and after 0.5. 1.5. 4, 8, 24, 48 and 72 hours. On average treatment was completed in 3 days. Results: Treatmentdependent reduction of all measured parameters in both
8.02+4.1
h 9.8+5,2 T 8.0+5,1 h rior AMIs:Group 1 15.10+5 pg/ml.Group hs 13.25~7 pg/ml
before
77
h ll.ZLI+;r pg/mI.Group 2 (7 AMIs): 7.56~5.2 h 10.86 pg/ml (p=ns).Antebefore 7 9.74+3,i h 10.64+4,2 h 2,before T 9.75tZ.4.1 h 10.25+1.2,2 (p-ns).Our data suggest that C
does not affect EN release during T in the anterior AMIs show a larger release as reported in the litermre.
AMI,and of EN
Simultaneously low molecular weight (LMW)-FgD products (P) (Fragment D) and Fibrin (Fb)-DP (fragment D-D) increased from 0.55 f. 0.42 to 3.31 f 5.69 mg/l and from 0.61 ? 0.83 to 6.58 + 6.78 mg/l respectively. Furthermore, high (H) MW FgDP (250300 000 d) were detected in the plasmas of 14 pts (8 PUK, 6 rt-PA) with means of SDS-PAGE (Polyacrylamid-gradient 6- 12%, 25OV, 30 mA, silver staining). The detection of HMW-FgDP was correlated to the consumption of PLG and a-2-AP levels. We conclude: that the Fg fragmentation - pattern of all PLG-activators is similar and the detection of HMW-FgDP is correlated to the extent of systemic lytic state exerted by T. The impact of the HMWFgDP on the incidence of secondary bleeds however remains to be elucidated.
arterial and venous samples was observed. Drop in plg concentration was significant (p
212
EFFFCTS OF CAPTOPRIL ON ENDOTHFL IN RELEASF DURING THROML3OLVSIS.PRELIMINARV RESULTS. Di Pasquale P,Paterna S,Parrinello G,Bucca V,CaraUSI K,Plpltone t.Licata ti. G.F.Ingrassia Hospital,Department Internal Medicine, University of PalermoJtaly. Aim of the study was to verify on the man if capto pril was able to reduce endothelin (EN) levels during thrombolysis(T) in acute myocardial infarction (AMI). pts hospitalised within 4 hs from the onset of symptoms. suitable for T(first episode),Killip randomised (double class I-2,all reperfused,were blind) into 2 Groups.Group 1: 15 pts (2F/l3M),mean age 58 ysreceived C 6.25 mg orally as first dose,15 min before T.Group Xplacebo) 12 pts (PF/lOM).mean age 64 ys,T only.Plasma levels of EN were checked before T,and at 1 and 2 hs,after T.Results:group 1 (5 unstable angina and 10 AMIs):before I 7.59+4.at 1 h 8.13+5.2 hs 9.99~7 pg/ml.Group 2 (control):(S UA and 7 AMIs) before T 7.41+4,1 h 7.09t5.2 hs 9.6146 only:Group 1 (IO AMIs) before -T pg/ml(p-ns).AMIs
213 Fragmentation
Pattern of Fibrinogen during Thrombolvsis in Acute Mvocardial Infarction with Fibrin-spe&ic plasmionogen activators - Detection of high molecular weight fibrinogen split products. H Thodel R. Dechend2, T. Miiller3, W.E. Eisert3, A, M. Barthelsl, D.C. Gulba2 Medizinische Hochschule Hannover (l), UKRV Franz-Volhard-Klinik, Free University Berlin (2), Dr. Karl Thomae GmbH, Biberach, Germany (3) In thrombolysis (T) in acute myocardial infarction (AMI), the fibrin specific plasminogen activators (PA) are infused in non physiologically high doses. Only limited fibrin-specific in nature, this may give rise to fibrinogen degradation (FgD). In a series of 75 patients (pts) - 24 rt-PA, 51 Pro-urokinase (PUK) we investigated, whether FgD follows a similar fragmentation pattern as known from T with streptokinase. During T, Fg levels (Ratnoff-Menzie) were stabel ( 3.2 f I,7 to 3.1 f 1.3 g/l/n.s.).
214
INTRAARTERIAL FIBRINOLYTIC PARAMETERS DURING LOCAL LOW DOSE STREPTOKINASE THERAPY. Kozak M, SaboviC M Trnovo Hospital of Internal Medicine, University Medical Centre, Ljubljana. Slovenia. Infroducfion: During local low dose intraarterial streptokinase thrombolysis some authors registereq a reduction in systemic (venous) plasminogen.(plg) and fibrinogen (fbg) concentrations. The aim of our study was to find out whether the degree of plg depletion is even more pronounced in the artery close to the thrombus. Patients and methods: 34 patients, treated with intraarterial streptokinase (3750 U/h) due to occlusive arterial disease of lower limbs, were included. The concentrations of pig. fbg and alfa-2 antiplasmin were measured in blood samples collected simultaneously from peripheral vein and from intraarterial catheter before drug administration and after 0.5. 1.5. 4, 8, 24, 48 and 72 hours. On average treatment was completed in 3 days. Results: Treatmentdependent reduction of all measured parameters in both
8.02+4.1
h 9.8+5,2 T 8.0+5,1 h rior AMIs:Group 1 15.10+5 pg/ml.Group hs 13.25~7 pg/ml
before
77
h ll.ZLI+;r pg/mI.Group 2 (7 AMIs): 7.56~5.2 h 10.86 pg/ml (p=ns).Antebefore 7 9.74+3,i h 10.64+4,2 h 2,before T 9.75tZ.4.1 h 10.25+1.2,2 (p-ns).Our data suggest that C
does not affect EN release during T in the anterior AMIs show a larger release as reported in the litermre.
AMI,and of EN
Simultaneously low molecular weight (LMW)-FgD products (P) (Fragment D) and Fibrin (Fb)-DP (fragment D-D) increased from 0.55 f. 0.42 to 3.31 f 5.69 mg/l and from 0.61 ? 0.83 to 6.58 + 6.78 mg/l respectively. Furthermore, high (H) MW FgDP (250300 000 d) were detected in the plasmas of 14 pts (8 PUK, 6 rt-PA) with means of SDS-PAGE (Polyacrylamid-gradient 6- 12%, 25OV, 30 mA, silver staining). The detection of HMW-FgDP was correlated to the consumption of PLG and a-2-AP levels. We conclude: that the Fg fragmentation - pattern of all PLG-activators is similar and the detection of HMW-FgDP is correlated to the extent of systemic lytic state exerted by T. The impact of the HMWFgDP on the incidence of secondary bleeds however remains to be elucidated.
arterial and venous samples was observed. Drop in plg concentration was significant (p