Why the study?
Does desmopressin acetate infusion compared to venous occlusion better evaluate fibrinolytic capacity in patients with coronary artery disease?
Does desmopressin acetate infusion compared to venous occlusion better evaluate fibrinolytic capacity in patients with coronary artery disease?
A DDAVP infusion test is more appropriate than venous occlusion for evaluating fibrinolytic capacity in patients with coronary artery disease due to its significant and prolonged effect on PAI levels.
Answers are grounded in this paper and cite their sources.
DDAVP may better assess fibrinolytic capacity than venous occlusion; leaves open clinical utility and validation in CAD.
A 20-min venous occlusion and a desmopressin acetate (DDAVP, 0.4 microgram.Kg-1, 15 min) infusion test have been compared to evaluate fibrinolytic capacity in proven coronary artery disease. Basal values of plasma tissue plasminogen activator (t-PA) activity and antigen and of t-PA inhibitor (PAI) were normally distributed in this patient group. However, after both stimuli, highly significant (P less than 0.005) increases of t-PA antigen and activity have been observed. Renormalization of t-PA levels after DDAVP infusion occurred more rapidly for antigen (120 min) than for activity concentrations (greater than 240 min). A DDAVP infusion test seems more appropriate for evaluation of the fibrinolytic capacity as the induced decrease in PAI level was significant (P less than 0.005) and lasted for at least 240 min, while it was not significant for the venous occlusion test.
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Duprez et al. (1991) studied this question.
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