TY - JOUR
T1 - Partial resistance to anticoagulation after streptokinase treatment for acute myocardial infarction
AU - Zahger, Doron
AU - Maaravi, Yoram
AU - Matzner, Yaacov
AU - Gilon, Dan
AU - Gotsman, Mervyn S.
AU - Weiss, A. Teddy
PY - 1990/7/1
Y1 - 1990/7/1
N2 - This study examines the response of 3 different groups of patients to anticoagulants: 50 patients previously treated with streptokinase for acute myocardial infarction (AMI) (group 1), 24 patients with AMI who had received anticoagulants without prior thrombolysis (group 2) and 11 subjects who received anticoagulants for noncoronary indications (group 3). No significant differences were detected between groups 2 and 3; therefore, they were combined for analysis. After streptokinase, patients required 37,755 ± 1,516 (mean ± standard error of the mean) U of heparin per day to achieve the desired activated partial thromboplastin time (APTT). The dosage was 30,294 ± 1,089 U/day in patients without antecedent thrombolysis (p < 0.001). Group 1 patients required 5 ± 0.4 days until adequate anticoagulation was achieved, compared with 3 ± 0.2 days in the control group (p = 0.01). Despite higher heparin requirements, group 1 patients had a tower APTT value than the other subjects (87 ± 5 vs 101 ± 6 seconds, p = 0.08). Group 1 patients required 5 ± 0.3 days to reach anticoagulation with warfarin versus 4 ± 0.2 days in groups 2 + 3 (p = 0.05). Comparison of groups 1 and 2 yielded similar, although smaller, differences. Patients treated with streptokinase for AMI seem to be partially resistant to anticoagulation, which may increase the risk of reocclusion.
AB - This study examines the response of 3 different groups of patients to anticoagulants: 50 patients previously treated with streptokinase for acute myocardial infarction (AMI) (group 1), 24 patients with AMI who had received anticoagulants without prior thrombolysis (group 2) and 11 subjects who received anticoagulants for noncoronary indications (group 3). No significant differences were detected between groups 2 and 3; therefore, they were combined for analysis. After streptokinase, patients required 37,755 ± 1,516 (mean ± standard error of the mean) U of heparin per day to achieve the desired activated partial thromboplastin time (APTT). The dosage was 30,294 ± 1,089 U/day in patients without antecedent thrombolysis (p < 0.001). Group 1 patients required 5 ± 0.4 days until adequate anticoagulation was achieved, compared with 3 ± 0.2 days in the control group (p = 0.01). Despite higher heparin requirements, group 1 patients had a tower APTT value than the other subjects (87 ± 5 vs 101 ± 6 seconds, p = 0.08). Group 1 patients required 5 ± 0.3 days to reach anticoagulation with warfarin versus 4 ± 0.2 days in groups 2 + 3 (p = 0.05). Comparison of groups 1 and 2 yielded similar, although smaller, differences. Patients treated with streptokinase for AMI seem to be partially resistant to anticoagulation, which may increase the risk of reocclusion.
UR - http://www.scopus.com/inward/record.url?scp=0025290537&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(90)90730-O
DO - 10.1016/0002-9149(90)90730-O
M3 - Article
AN - SCOPUS:0025290537
SN - 0002-9149
VL - 66
SP - 28
EP - 30
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 1
ER -