Relation of coagulation parameters to patency and recurrent ischemia in the Thrombolysis in Myocardial Infarction (TIMI) Phase II Trial

R. P. Tracy, Neal Kleiman, B. Thompson, C. P. Cannon, E. G. Bovill, R. G. Brown, D. Collen, E. Mahan, K. G. Mann, W. J. Rogers, G. Sopko, D. C. Stump, D. O. Williams, B. I. Zaret

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Current protocols for use of tissue-type plasminogen activator in acute myocardial infarction include heparin estimated by the activated partial thromboplastin time (aPTT). Recent reports indicate a risk of recurrent ischemic events with long aPTT values. Longer aPTT values in the Thrombolysis in Myocardial Infarction-II (TIMI II) Trial, obtained within the first 48 hours, were associated with patency at 18 to 48 hours and better left ventricular function at discharge (average 9.6 days), but also with emergency catheterizations within the first 48 hours and, weakly, with recurrent ischemia during the first 18 hours. A moderate decrease in fibrinogen, compared with a 'small' decrease, was also associated with patency, but a 'large' decrease was associated with hemorrhagic events. Patency was associated with higher fibrinogen values and higher plasminogen values at baseline. The aPTT results support frequent monitoring during the first 24 to 48 hours to ensure optimal clinical outcome. The coagulation factor results suggest that there may be an optimum window for fibrinogenolysis in this setting.

Original languageEnglish (US)
Pages (from-to)29-37
Number of pages9
JournalAmerican Heart Journal
Volume135
Issue number1
DOIs
StatePublished - Jan 1 1998

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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