Ethanol gelation test in acute myocardial infarction

THROMBOSIS RESEARCH Printed in the

United

vo1.2, pp. 173-176, 1973 Pergamon Press, Inc.

States

COMMUNICATION

BRIEF

ETHANOL GELATION TEST IN ACUTE MYOCARDIAL INFARCTION

Harald Arnesen, Hans Christian Godal and Peter Kierulf Hematological Research Laboratory, Department IX, Ullevsl Hospital, University Clinic, Oslo, Norway.

(Received

29.12.1972.

Accepted

by

Editor

B.

Blomb&ck)

INTRODUCTION Interest has been focused on thrombotic complications during the acute phase of myocardial infarction.

With the use

of 1125 -fibrinogen a high incidence of calf-vein thrombosis has been reported (1, 21, and increased levels of serum fibrin/ fibrinogen degradation products (FDP) have been detected (3). Increased FDP has been suggested to be of prognostic value, being associated with a significant increased mortality (3, In the present study,

the

ethanol

gelation

test

(5) was per-

formed on admission in 80 patients with acute myocardial infarction, and correlated to the hospital mortality.

173

4).

ETHANOL

174

GELATION

TEST

Vo1.2,No.2

MATERIALS. METHODS and RESULTS 1 Pltlcmas from 80 coriscculivc pa 1icrlL:: willi ;lcuLc myocaI~(li;l

infarction were tested with the ethanol gelation test.

The

patients were part of the European urokinase trial in myocardial infarction (6).

According to the protocol of' this trial,

all patients had symptoms of less than 12 hours duration, pathognomonic ECG changes, and were all treated in a coronary care unit. The ethanol gelation test was performed accordirlg Lo the original description (5). As shown in Table I, a positive test was found in 17 patients (21%).

The death rate among these was 47%, as compared

to 14% among patients with a negative test.

The frequency of

thrombotic complications was not studied.

TABLE I Ethanol gelation test releated to hospital mortality in patients with acute myocardial infarction. No.

Deaths

Positive ethanol gelation test

17

a (47%)

Negative ethanol gelation test

63

9 (14%)

Total

a0

17 (21%)

DISCUSSION A positive ethanol gelation test appears to be a sensitive indicator of fibrinemia (7, a).

The present results seem to

fit with the reported high incidence of early thrombotic com-

ETHANOL

Vol.Z,No.2

GELATION

175

TEST

plications in patients with acute myocardial infarction (1, 2), and are well correlated with the mortality among patients with elevated serum FDP (3). A positive ethanol gelation test within 12 hours after on-

:;c:t

of’ an

acuto myocardial irlfarclion m:ly Ltiu:;bc 2. bad prog-

nostic sign.

Whether intravascular coagulation contributes to

an cvcntual fatal outcome, or is only indicntivc of a :;criou:: disease state (71, remains to be settled. REFERENCES 1.

MAURER, B.J., WRAY, R. and SHILLINGFORD, J.P. Frequency of venous thrombosis after myocardial infarction. Lancet, 2, 1385,

3 L.

1971.

NICOLAIDES, A.N., KAKKAR, V.V., RENNEY, J.T.G., KIDNEH, P.H., HUTCHINSON, D.C.S. and CLARKE, M.B. and deep-vein thrombosis.

3.

Myocardial infarction

Brit.Med.J. 1, 432, 1971.

BAELE, G., MUSSCHE, M. and VERMEIRE, P.

Serum fibrin/fi-

brinogen degradation products in acute myocardial infztion. 689,

Lancet, 1, 4.

1972.

ALMER, L.O., HEDNER, U. and NILSSON, I.M. Fibrin degradation products in the early differential diagnosis of myocardial infarction.

5.

GODAL, H.C. and ABILDGAARD, U. in plasma by ethanol.

6.

Thrombosis Res. 1, 59, 1972. Gelation of soluble fibrin

Scand.J.Haemat. 1, 342, 1966.

EUROPEAN UROKINASE TRIAL IN MYOCARDIAL INFARCTION.

To be

published. 7.

KIERULF, P. and GODAL, H.C.

Fibrinemia in medical patients

screened by the ethanol gelation test.

Acta med.scand. 190,

1971. 8.

KIERULF, P.

Studies on soluble fibrin in plasma.

II. N-

terminal analysis of a modified fraction I (Cohn) from patierk plasmas.

Scand.J.clin.Lab.Invest.

3,

1973

(In press).