Study of blood clotting and fibrinolysis during r-TPA infusion in patients with acute myocardial infarction

Suppl . VI,

1986

THROMBOSIS RESEARCH

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40 STUDYOF BLOODCLOlTIffiANDFIERINOLYSIS DURIffi r-TPA IKUSIONIN PATIENTS WITHACUTE MYCEARDIAL IN!KTION. G.G.Nwi Serneri, G.F.Gensini,R.Abbate,D.Prisco,P.A.Modesti, ClinicaMedica I, Universityof Florence - A.Branzi, GMelandri, B.Magnani, 1st. Mal. App. Cardiovascolare, Universityof Bologna,Italy. This studywas performedin order to investigate the effectsof r-TPA infusionon blood-clotting and fibrinolyticsystemand to evaluatethe haemorrhagic risk. Sixteen patients with acute myocardial infarctionwere investigated;10 were treatedwith r-TPA (infusediv at 0.75 &/kg body weight in 90 min.1 plus conventional therapy; 6 patientstreatedwith conventional therapy alone,servedas controls.Blocd sampleswere withdrm by clean venipuncture ianediately before, 60 and 85 min after the beginningof the infusion. Fibrinolytic activity was evaluated by measuring plasma levels of plasmincgenand alpha-2antiplasmin(Friberger et al 1978) and fibrinogendegradationproducts(FDP) (assayedby Staphyloccccal ClumpingTest; Hasviger19701. Blood clotting was evaluatedby measuringaPll, prothrtiin time, fibrinogen plasma levels (Clauss1957)and antithtiin III activity(0degar-d et al. 1975).No significant mxlifications of the paramreters evaluated were observedin the 6 patientstreatedonly with conventional therapy. In all the patientstreatedwith r-TPA fibrinolytic activityincreasedafter60 and 85 min: plasminogen, fibrinogenand alpha-2antiplasminsignificantly decreased(pa.05 to p