PMID- 9031450
OWN - NLM
STAT- MEDLINE
DCOM- 19970429
LR  - 20061115
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 77
IP  - 1
DP  - 1997 Jan
TI  - Systemic thrombin generation and activity resistant to low molecular weight 
      heparin administered prior to streptokinase in patients with acute myocardial 
      infarction.
PG  - 57-61
AB  - One hundred patients were included in a randomized open trial to assess the 
      systemic factor Xa (FXa) and thrombin inhibitory effect as well as the safety 
      profile of low molecular weight heparin (LMWH) given subcutaneously in 
      conjunction with streptokinase (SK) in patients with acute myocardial infarction 
      (MI). The treatment was initiated prior to SK, followed by repeated injections 
      every 12 h for 7 days, using a dose of 150 anti-Xa units per kg body weight. The 
      control group received unfractionated heparin (UFH) 12,500 i.u. subcutaneously 
      every 12 h for 7 days, initiated 4 h after start of SK infusion. All patients 
      received acetylsalicylic acid (ASA) initiated prior to SK. Serial blood samples 
      were collected prior to and during the first 24 h after initiation of SK infusion 
      for determination of prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin 
      III (TAT) complexes, fibrinopeptide A (FPA) and cardiac enzymes. Bleeding 
      complications and adverse events were carefully accounted for. Infarct 
      characteristics, as judged by creatine kinase MB isoenzyme (CK-MB) and cardiac 
      troponin T (cTnT), were similar in both groups of patients. A comparable 
      transient increase in F1 + 2, TAT and FPA was noted irrespective of heparin 
      regimen. Increased anti-Xa activity in patients given LMWH prior to thrombolytic 
      treatment had no impact on indices of systemic thrombin activation. The incidence 
      of major bleedings was significantly higher in patients receiving LMWH as 
      compared to patients receiving UFH. However, the occurrence of bleedings was 
      modified after reduction of the initial LMWH dose to 100 anti-Xa units per kg 
      body weight. In conclusion, systemic FXa- and thrombin activity following 
      SK-infusion in patients with acute MI was uninfluenced by conjunctive LMWH 
      treatment.
FAU - Nilsen, D W
AU  - Nilsen DW
AD  - Dept. of Medicine, Central Hospital in Rogaland, Stavanger, Norway.
FAU - Goransson, L
AU  - Goransson L
FAU - Larsen, A I
AU  - Larsen AI
FAU - Hetland, O
AU  - Hetland O
FAU - Kierulf, P
AU  - Kierulf P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - EC 3.4.- (Streptokinase)
RN  - EC 3.4.21.5 (Thrombin)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Acute Disease
MH  - Factor Xa/metabolism
MH  - Female
MH  - Fibrinolytic Agents/*administration & dosage
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Infarction/blood/drug therapy
MH  - Streptokinase/*administration & dosage
MH  - Thrombin/*metabolism
EDAT- 1997/01/01 00:00
MHDA- 1997/01/01 00:01
CRDT- 1997/01/01 00:00
PHST- 1997/01/01 00:00 [pubmed]
PHST- 1997/01/01 00:01 [medline]
PHST- 1997/01/01 00:00 [entrez]
PST - ppublish
SO  - Thromb Haemost. 1997 Jan;77(1):57-61.