PMID- 15673542
OWN - NLM
STAT- MEDLINE
DCOM- 20050616
LR  - 20061115
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 26
IP  - 5
DP  - 2005 Mar
TI  - Predictors of the rise in vWF after ST elevation myocardial infarction: 
      implications for treatment strategies and clinical outcome: An ENTIRE-TIMI 23 
      substudy.
PG  - 440-6
AB  - AIMS: Prior studies suggest that acute coronary syndromes (ACSs) are associated 
      with endothelial activation and that this is of prognostic significance. We 
      hypothesized that endothelial activation, as measured by a rise in von Willebrand 
      Factor (DeltavWF), was influenced by the thrombolysis in myocardial infarction 
      flow grade (TFG), the corrected TIMI frame count (CTFC) and the choice of 
      anticoagulant therapy after fibrinolysis in ST elevation myocardial infarction 
      (STEMI). METHODS AND RESULTS: Data were drawn from the enoxaparin and 
      tenecteplase tissue plasminogen activator (TNK-tpa) with or without GPIIb/IIIa 
      inhibitor as the reperfusion strategy in the STEMI trial (ENTIRE-TIMI 23). Three 
      hundred and fourteen patients had serial measurements of vWF (baseline and 48-72 
      h) and angiographic data available. TFG<3 (P=0.0042) or CTFC>/=40 at 60 min 
      (P=0.0035) were associated with a higher DeltavWF. DeltavWF >/=75th percentile 
      was associated with a higher incidence of death or myocardial infarction (MI) at 
      30 days, compared with <75th percentile (11.2 vs. 4.1%, P=0.027). Enoxaparin 
      independently reduced the DeltavWF (P=0.019) and also the composite of death or 
      MI (OR 0.33, 95% CI 0.12-0.91, P=0.03) compared with unfractionated heparin. 
      CONCLUSION: In STEMI treated by fibrinolysis, coronary flow at 60 min and choice 
      of adjunctive anticoagulant appear to be independent determinants of DeltavWF. 
      Enoxaparin is independently associated with a reduction in DeltavWF and a 
      reduction in death or MI. The clinical benefits of enoxaparin as an adjunctive 
      treatment in STEMI may be mediated in part by a reduction in vWF release.
FAU - Ray, Kausik K
AU  - Ray KK
AD  - TIMI Study Group and Cardiovascular Division, Department of Medicine, Brigham & 
      Women's Hospital/Harvard Medical School, Boston, MA, USA. kkray@partners.org
FAU - Morrow, David A
AU  - Morrow DA
FAU - Gibson, C Michael
AU  - Gibson CM
FAU - Murphy, Sabina
AU  - Murphy S
FAU - Antman, Elliott M
AU  - Antman EM
FAU - Braunwald, Eugene
AU  - Braunwald E
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20050126
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (von Willebrand Factor)
SB  - IM
CIN - Eur Heart J. 2005 Mar;26(5):421-2. PMID: 15695531
MH  - Blood Flow Velocity/physiology
MH  - Coronary Circulation
MH  - Coronary Vessels/physiology
MH  - Enoxaparin/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Male
MH  - Myocardial Infarction/*blood/drug therapy/mortality/physiopathology
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Thrombolytic Therapy/*methods
MH  - Treatment Outcome
MH  - von Willebrand Factor/*metabolism
EDAT- 2005/01/28 09:00
MHDA- 2005/06/17 09:00
CRDT- 2005/01/28 09:00
PHST- 2005/01/28 09:00 [pubmed]
PHST- 2005/06/17 09:00 [medline]
PHST- 2005/01/28 09:00 [entrez]
AID - ehi104 [pii]
AID - 10.1093/eurheartj/ehi104 [doi]
PST - ppublish
SO  - Eur Heart J. 2005 Mar;26(5):440-6. doi: 10.1093/eurheartj/ehi104. Epub 2005 Jan 
      26.