Key result
Higher early procoagulant markers linked to increased mortality, impaired TIMI flow, and bleeding in rt-PA-treated AMI.
Why the study?
Thrombin activity increases after thrombolytic therapy in AMI and may contribute to reperfusion failure and early reocclusion, but the role of hemostatic markers in predicting outcomes is unclear.
Do procoagulant and fibrinogenolytic markers predict clinical outcomes in patients with acute myocardial infarction treated with thrombolytic therapy?
Population
Patients with AMI enrolled in the TIMI-5 study treated with rt-PA and adjunctive antithrombotic therapy
Comparison
Hirudin versus heparin as adjunctive antithrombotic therapy with rt-PA
Design
Randomized, dose-ranging, pilot trial
Follow-up
Up to 24 hours
Authors
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May aid risk stratification in rt-PA-treated AMI; hypothesis-generating and requires prospective validation before guiding care.
RCT
randomized
Do procoagulant and fibrinogenolytic markers predict clinical outcomes in patients with acute myocardial infarction treated with thrombolytic therapy?
Procoagulant and fibrinogenolytic markers measured early after thrombolytic therapy for AMI may help predict mortality, reperfusion failure, and hemorrhagic events.
Scharfstein et al. (1996) conducted an RCT in Acute myocardial infarction. Hirudin vs. Heparin was evaluated on Clinical outcomes including mortality, TIMI flow grades, hemorrhagic events, and recurrent ischemia. Increased early levels of procoagulant markers (FPA, TAT, F1.2) were associated with increased mortality, impaired TIMI flow, and hemorrhagic events in AMI patients treated with rt-PA.
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