Effect of intravenous heparin infusion on thrombin-antithrombin complex and fibrinopeptide A in unstable angina

Détails

ID Serval
serval:BIB_C667EFFCA368
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Effect of intravenous heparin infusion on thrombin-antithrombin complex and fibrinopeptide A in unstable angina
Périodique
American Heart Journal
Auteur(s)
Mombelli  G., Marchetti  O., Haeberli  A., Straub  P. W.
ISSN
0002-8703 (Print)
Statut éditorial
Publié
Date de publication
12/1998
Volume
136
Numéro
6
Pages
1106-13
Notes
Journal Article --- Old month value: Dec
Résumé
BACKGROUND: In unstable angina, the clinical efficacy of heparin is limited in time, and recurrence of adverse events has been reported after discontinuation of the anticoagulant. METHODS: In 21 episodes of unstable angina, we used the plasma level of fibrinopeptide A (FPA) and of thrombin-antithrombin complex (TAT) to evaluate the pattern of thrombin inhibition by heparin and the effect of stopping heparin and initiating aspirin. RESULTS: At admission, the plasma level of FPA was increased: median value 3.7 ng/mL compared with 5.5 ng/mL in a control group of 20 patients with early myocardial infarction (not significant). The following findings were observed during a 4-day course of intravenous heparin infusion: (1) FPA decreased significantly 6 hours after the start of therapy; (2) FPA was lower when activated partial thromboplastic time (aPTT) was >1.5 times baseline; (3) there was a significant negative correlation between aPTT and FPA. Twenty-four hours after heparin was discontinued and aspirin initiated, a significant increase in TAT and FPA in plasma was observed. CONCLUSIONS: The results confirm ongoing fibrin formation in the active phase of unstable angina, indicate incomplete and variable inhibition of thrombin by heparin during continuous infusion, and suggest a risk of re-emergence of thrombosis (in spite of initiating aspirin) 24 hours after withdrawal of heparin. Data demonstrate a better control of thrombin activity when heparin is infused at rates that maintain aPTT at >1.5 times baseline, as currently recommended in unstable angina.
Mots-clé
Aged Angina, Unstable/*blood/*drug therapy Anticoagulants/*administration & dosage/therapeutic use Antithrombin III/*analysis Aspirin/administration & dosage/therapeutic use Biological Markers/blood Female Fibrinopeptide A/*analysis Heparin/*administration & dosage/therapeutic use Humans Infusions, Intravenous Male Middle Aged Peptide Hydrolases/*analysis Prospective Studies
Pubmed
Web of science
Création de la notice
25/01/2008 13:33
Dernière modification de la notice
20/08/2019 15:41
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