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- Title
A pilot study of streptokinase-induced endothelial injury and platelet activation following acute myocardial infarction.
- Authors
Lip, G. Y. H.; Lydakis, C.; Nuttall, S. L.; Landray, M. J.; Watson, R. D. S.; Blann, A. D.; Lip, G Y; Watson, R D
- Abstract
<bold>Objective: </bold>To relate the changes in serum vitamin E, an essential antioxidant, to changes in fibrinogen, as well as indices of endothelial damage [as indicated by plasma markers, soluble thrombomodulin (sTM) and von Willebrand factor (vWf), and an index of platelet activation (soluble P selectin (sPsel)], in myocardial infarction treated with thrombolytic therapy.<bold>Design and Setting: </bold>Prospective longitudinal pilot study in a teaching hospital Coronary Care Unit.<bold>Subjects and Intervention: </bold>Seventeen patients (12 men: mean age (62 years +/- SD 11 years) admitted with acute myocardial infarction (AMI), who were given thrombolytic therapy, and 59 healthy controls.<bold>Results: </bold>Baseline levels of fibrinogen (Mann-Whitney test, P = 0.0055) and vWf (P < 0.001) were significantly higher than controls, but sPsel, sTM or vitamin E levels were not significantly different. Following thrombolysis, as expected, median concentrations of plasma fibrinogen fell profoundly (Friedman ANOVA P < 0.001) so that after 45 min, levels were undetectable in 13 patients. At 24-h median fibrinogen concentration had recovered to approximately 30% of baseline (P < 0.01) and was still undetectable in three patients. Levels of vWf and sPsel increased steadily, reaching significance after three hours (both P < 0.05). However, levels of sTM rose immediately after thrombolysis, peaking between 1 and 3 h, and remained elevated at 24 h. These increases corresponded to a simultaneous early fall in serum vitamin E concentrations.<bold>Conclusion: </bold>The present pilot study demonstrates significant endothelial damage and platelet activation in association with increased oxidative stress following streptokinase therapy for AMI.
- Subjects
STREPTOKINASE; ENDOTHELIUM; MYOCARDIAL infarction complications; THROMBOLYTIC therapy; DRUG therapy; FIBRINOLYTIC agents; ANALYSIS of variance; ANTIGENS; BLOOD coagulation factors; BLOOD platelet activation; CELL receptors; COMPARATIVE studies; FIBRINOGEN; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MYOCARDIAL infarction; RESEARCH; VITAMIN E; PILOT projects; OXIDATIVE stress; EVALUATION research; CASE-control method; BLOOD
- Publication
Journal of Internal Medicine, 2000, Vol 248, Issue 4, p316
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1046/j.1365-2796.2000.00738.x