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The influence of acute-phase levels of haemostatic factors on reperfusion and mortality in patients with acute myocardial infarction treated with streptokinase
Örebro University, School of Health and Medical Sciences.
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2008 (English)In: Journal of Thrombosis and Thrombolysis, ISSN 0929-5305, E-ISSN 1573-742X, Vol. 26, no 3, p. 188-195Article in journal (Refereed) Published
Abstract [en]

Background The fibrinolytic system and von Willebrand factor (vWF) have been shown to play a role as risk factors for myocardial infarction. We performed this prospective cohort study to determine if components in the fibrinolytic system or vWF before or during treatment of AMI with streptokinase (SK) could predict reperfusion, recurrent ischaemia, reinfarction or mortality at one year, or mortality at five years. Reperfusion and recurrent ischaemia were assessed by continuous vectorcardiography. The setting was Umeå university hospital and Skellefteå county hospital, Sweden. Results 139 patients were included; successful reperfusion was obtained in 53%. tPA activity, PAI-activity, PAI-mass concentration and vWF were analysed immediately on arrival and after 4 and 10 h. High fibrinolytic activity, measured as tPA activity > 25 U/L after the start of treatment, was associated with reperfusion. No significant associations between pre-treatment levels of the fibrinolytic variables or vWF and reperfusion or recurrent ischaemia were found. Elevated levels of PAI-1 mass concentration and PAI-1 activity after the start of SK treatment were associated with a higher risk for death at one year, but not at five years. High levels of vWF were associated with worse prognosis but not when corrected for age. Conclusion Pre-treatment levels of PAI-1, vWF and tPA activity showed no association with reperfusion or recurrent ischaemia. Elevated levels of PAI-1 activity after the start of treatment were associated with worse prognosis.

Place, publisher, year, edition, pages
Berlin: Springer , 2008. Vol. 26, no 3, p. 188-195
National Category
Medical and Health Sciences Cardiac and Cardiovascular Systems Clinical Medicine
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-3513DOI: 10.1007/s11239-007-0086-9PubMedID: 17721741OAI: oai:DiVA.org:oru-3513DiVA, id: diva2:137810
Available from: 2008-12-08 Created: 2008-12-08 Last updated: 2017-12-14Bibliographically approved

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Nilsson, Torbjörn K.

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