TY - JOUR
T1 - Coronary thrombolysis with recombinant tissue-type plasminogen activator
T2 - A hematologic and pharmacologic study
AU - Topol, E. J.
AU - Bell, W. R.
AU - Weisfeldt, M. L.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1985
Y1 - 1985
N2 - The blood of 30 patients who received recombinant tissue-type plasminogen activator for lysis of acute coronary thrombosis was examined to identify the effects of this enzyme on the fibrinolytic and coagulation systems. Doses ranged from 20 to 80 mg and duration of infusion ranged from 15 minutes to 4.5 hours. Doses of 60 mg or less and duration of infusion of 2 hours or less caused only mild fibrinogenolysis, a 28% drop from baseline plasma fibrinogen concentrations to nadir. In contrast, higher doses or longer infusion periods led to significantly lower fibrinogen levels, a 61% decrease of fibrinogen levels at nadir (p < 0.01), and this effect was sustained. Dosing by weight led to less appreciable fibrinogen breakdown. A strong negative correlation was seen between plasma plasminogen activator and fibrinogen levels (r = -0.83, p < 0.001) during the infusion. In-vitro studies showed the enzyme to deplete fibrinogen rapidly, and this activation was blocked with a protease inhibitor.
AB - The blood of 30 patients who received recombinant tissue-type plasminogen activator for lysis of acute coronary thrombosis was examined to identify the effects of this enzyme on the fibrinolytic and coagulation systems. Doses ranged from 20 to 80 mg and duration of infusion ranged from 15 minutes to 4.5 hours. Doses of 60 mg or less and duration of infusion of 2 hours or less caused only mild fibrinogenolysis, a 28% drop from baseline plasma fibrinogen concentrations to nadir. In contrast, higher doses or longer infusion periods led to significantly lower fibrinogen levels, a 61% decrease of fibrinogen levels at nadir (p < 0.01), and this effect was sustained. Dosing by weight led to less appreciable fibrinogen breakdown. A strong negative correlation was seen between plasma plasminogen activator and fibrinogen levels (r = -0.83, p < 0.001) during the infusion. In-vitro studies showed the enzyme to deplete fibrinogen rapidly, and this activation was blocked with a protease inhibitor.
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U2 - 10.7326/0003-4819-103-6-837
DO - 10.7326/0003-4819-103-6-837
M3 - Article
C2 - 3933395
AN - SCOPUS:0022411596
SN - 0003-4819
VL - 103
SP - 837
EP - 843
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 6 I
ER -