Value of measurements of thrombin generation markers and D-dimer during coronary thrombolytic therapy-the early prediction of Re-infarction

Abstract EN

The Therapeutic intravenous (IV) thrombolysis has been proven to be highly effective in re-perfusing occluded coronary arteries after acute myocardial infarction (AMI).

We studied the course of thrombin-antithrombin III complex (TAT) and prothrombin fragment 1+2 (Fl+2), as thrombin generation markers, as well as D-dimer levels in 44 patients who had AMI.

Twenty of the included patients sufferedfrom re-infarction during their convalescence (on the 2nd to 7lh day).

All patients received streptokinase, heparin and aspirin on admission Blood samples for assay were collected at 0,2,5,7 and 15 days after the onset of AMI.

The 3 variables studied were all able to discriminate between patients who developed re-infarction from those who did not during the period of the study.

TAT was found to increase early in complicated group than in non-complicated group.

Fl +2 started to show significant increase on the 7'h day in the former than the latter group.

The D-dimer levels started to increase significantly, only 5 days after the first infarction in complicated group, and started to decrease after the 1st week but remained elevated up to the 2nd week In conclusion, we have demonstrated that during thrombolytic therapy with streptokinase, the coagulation system is activated Still, we cannot predict early re-infarction by estimating plasma levels ofFl +2 and D-dimer.

Although TAT may be of some value in this situation.