What question did this study set out to answer?

To determine the effects of intravenous heparin on thrombin generation markers in patients with acute coronary syndromes.

July 1, 1997Arteriosclerosis Thrombosis and Vascular BiologyOpen Access

Persistent Thrombin Generation During Heparin Therapy in Patients With Acute Coronary Syndromes

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Why the study?

Does intravenous heparin reduce thrombin generation (measured by prothrombin fragment 1+2) in patients with acute coronary syndromes?

Population

64 consecutive patients with unstable angina or myocardial infarction

Design

Cohort

Follow-up

48 hours

Authors

PMPiera Angelica MerliniGeneral / Preventive / Lipids DADiego ArdissinoInterventional / Structural Cardiology KBKenneth A. BauerBoston University

Discussion

Member takes

Implication

Heparin was associated with suppressed thrombin activity but not generation in ACS; leaves open need for generation-targeted therapies.

Key Points

To determine the effects of intravenous heparin on thrombin generation markers in patients with acute coronary syndromes.
Measuring plasma levels of prothrombin fragment 1+2, fibrinopeptide A, and antithrombin III in 64 patients.
Blood samples collected at baseline, 90 minutes, 24 hours, and 48 hours post-heparin administration.
Heparin administered at an intravenous bolus of 5000 IU followed by a continuous infusion of 1000 IU per hour.
Fibrinopeptide A significantly decreased from baseline (2.3 nmol/L) to 90 minutes (1.15 nmol/L), 24 hours (1.4 nmol/L), and 48 hours (1.2 nmol/L); P < .0001.
Prothrombin fragment 1+2 levels showed no significant change at any time point; P = NS.
Antithrombin III activity decreased from baseline (108%) at 24 hours (97%) and 48 hours (95%); P < .0001.

Structured PICO

Does intravenous heparin reduce thrombin generation (measured by prothrombin fragment 1+2) in patients with acute coronary syndromes?

Population

64 consecutive patients with unstable angina or myocardial infarction

Intervention

Intravenous heparin (5000 IU bolus followed by continuous infusion of 1000 IU per hour to maintain activated partial thromboplastin time at more than double its baseline levels) over 48 hours

Outcome

Plasma levels of prothrombin fragment 1+2, fibrinopeptide A, and antithrombin III at 90 minutes, 24 hours, and 48 hourssurrogate

Intravenous heparin adequately suppresses thrombin activity but fails to suppress persistent thrombin generation in patients with acute coronary syndromes.

Cite This Study

Merlini et al. (1997) studied this question.

synapsesocial.com/papers/6a707d155d37378ac1dd984b https://doi.org/10.1161/01.atv.17.7.1325

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Persistent Thrombin Generation During Heparin Therapy in Patients With Acute Coronary Syndromes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Persistent Thrombin Generation During Heparin Therapy in Patients With Acute Coronary Syndromes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Also Consider