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Titolo:
PLATELET ACTIVITY IN THE EARLY-STAGE OF ACUTE MYOCARDIAL-INFARCTION -RELATION TO TIME OF PRESENTATION, TREATMENT WITH EITHER TISSUE-PLASMINOGEN ACTIVATOR OR STREPTOKINASE AND CYCLOOXYGENASE INHIBITION
Autore:
SALVIONI A; PEREGO GB; MARENZI G; GALLI S; ASSANELLI E; GUAZZI MD;
Indirizzi:
IRCCS,FDN MONZINO,CTR CARDIOL,IST CARDIOL,VIA PAREA 4 I-20138 MILAN ITALY UNIV MILAN,IST CARDIOL MILAN ITALY CNR,CTR STUDIO RIC CARDIOVASC MILAN ITALY
Titolo Testata:
Journal of thrombosis and thrombolysis
fascicolo: 1, volume: 5, anno: 1998,
pagine: 65 - 71
SICI:
0929-5305(1998)5:1<65:PAITEO>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
THROMBOLYTIC THERAPY; CORONARY THROMBOLYSIS; BETA-THROMBOGLOBULIN; CANINE PREPARATION; THROMBOXANE-A2; REOCCLUSION; THROMBOSIS; INVIVO; FIBRINOLYSIS; AGGREGATION;
Keywords:
ASPIRIN; PLATELET ACTIVITY; THROMBOLYTIC THERAPY; MYOCARDIAL INFARCTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
A. Salvioni et al., "PLATELET ACTIVITY IN THE EARLY-STAGE OF ACUTE MYOCARDIAL-INFARCTION -RELATION TO TIME OF PRESENTATION, TREATMENT WITH EITHER TISSUE-PLASMINOGEN ACTIVATOR OR STREPTOKINASE AND CYCLOOXYGENASE INHIBITION", Journal of thrombosis and thrombolysis, 5(1), 1998, pp. 65-71

Abstract

Background. Platelet activation after myocardial infarction and thrombolytic treatment has been documented; but its relationship with the onset of symptoms and with thrombolysis, and the influence of aspirin in this setting is not well defined. In this study we measured plateletactivity in the early phase of myocardial infarction treated with either streptokinase or rt-PA and evaluated influence of aspirin in this framework. Methods. 41 patients (age 57 +/- 6 years) were treated withthrombolytic therapy during myocardial infarction; 21 patients with 1,5 million units of streptokinase (Group 1) and 20 patients with 100 mg of rt-PA (Group 2); 10 randomly selected patients in each group weregiven 500 mg aspirin i.v. prior to infusion of thrombolytic drug and,subsequently, 325 mg aspirin a day orally. Consecutive samples of beta thromboglobulin (BTG), a marker of platelet activity, were collectedat admission and after thrombolysis for the following 48 hours. Results. At admission, BTG plasma levels averaged 125 +/- 31 IU/ml in Group1 and 134 +/- 35 IU/ml in Group 2 (p = 0.81). Thrombolysis was followed by a similar increase of platelet activity with maximal values reached at the 3rd hour in both groups (196 +/- 43 IU/ml in Group 1 and 192 +/- 39 in Group 2: p < 001 versus baseline and p NS between the groups). Higher levels of BTG were observed in streptokinase-treated groupstarting from the 24th hour (p < 0.05). Patients treated with aspirinshowed lower levels of BTG only from the 48th hour after thrombolysisin both groups. An inverse correlation was found between time elapsedfrom onset of symptoms to admission and BTG value on admission (r = -0.86 p < 0.001); in patients admitted within two hours from the beginning of symptoms, with higher levels of BTG, thrombolysis not induced asignificant increase of platelet activity; who was observed in patients admitted later. Conclusions. A marked platelet activation is more evident in the first hours of myocardial infarction and is differently influenced by thrombolytic treatment in relation with the delay of patient presentation. Both streptokinase and rt-PA in duce a similar increase of platelet activity which is more persistent after streptokinase; cyclooxygenase inhibition seems to influence the platelet activity only from the second day. Condensed abstract. Influence of aspirin on platelet activity during myocardial infarction treated with thrombolytic therapy is not well defined. Twenty-one patients treated with streptokinase (Group 1) and 20 patients treated with rt-PA (Group 2) were randomly selected to give 500 mg of aspirin i;v, prior thrombolysis and subsequently 325 mg a day orally. Platelet activity was evaluated through determination of beta-thromboglobulin plasma levels. Thrombolysis was followed by a similar increase of platelet activity in both groupswith maximal values reached at the 3rd hour; higher levels of beta thromboglobulin were observed in streptokinase-treated group starting from 24th hour. Treatment with aspirin reduced beta-thromboglobulin plasma levels only at 48th hour in both groups.

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Documento generato il 13/07/20 alle ore 07:04:11