Course of indicators of thrombin activity in the early phase of acute myocardial infarction: effect of fibrinolytic therapy and acute percutaneous coronary angioplasty

Carl-Erik Dempfle; Jens J. Kaden; Karl K. Haase; Martin Borggrefe

doi:10.1055/s-0037-1613611

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2003; 90(01): 147-154
DOI: 10.1055/s-0037-1613611

New Technologies and Diagnostic Tools

Schattauer GmbH

Course of indicators of thrombin activity in the early phase of acute myocardial infarction: effect of fibrinolytic therapy and acute percutaneous coronary angioplasty

Carl-Erik Dempfle

¹University Hospital of Mannheim, I. Department of Medicine, Mannheim, Germany

,

Jens J. Kaden

¹University Hospital of Mannheim, I. Department of Medicine, Mannheim, Germany

,

Karl K. Haase

¹University Hospital of Mannheim, I. Department of Medicine, Mannheim, Germany

,

Martin Borggrefe

¹University Hospital of Mannheim, I. Department of Medicine, Mannheim, Germany

› Author Affiliations

Abstract

Summary

We evaluated assay systems for detection of in vivo thrombin activity in patients with acute myocardial infarction. The study included 31 consecutive patients with acute myocardial infarction treated either with fibrinolytic therapy (FLT), or acute PTCA. Blood samples were drawn at admission, after 30 min, 1 h, 3 h, 6 h, 12 h, 24, and 48 h. Assays related to the enzymatic action of thrombin included fibrinopeptide A ELISA, a novel latex-enhanced photometric immunoassay for soluble fibrin complexes, fibrin monomer antigen, D-dimer antigen, and soluble platelet glycoprotein V, which is released from the platelet surface by thrombin cleavage.

The soluble fibrin assay displayed a high degree of correlation with fibrinopeptide A, and no correlation with D-dimer antigen, indicating that this parameter allows monitoring of in vivo thrombin activity in patients with acute myocardial infarction. Fibrin monomer antigen, and D-dimer antigen, were influenced by FLT, indicating cross-reactivity with proteolytic fragments of fibrin. No significant changes in soluble glycoprotein V were observed.

The results show that the novel soluble fibrin assay appears to be a promising method for measurement of in vivo fibrin formation in patients with acute myocardial infarction, irrespective of the primary treatment decision for FLT or acute PTCA.

Keywords

Fibrinopeptide A - fibrin monomer - soluble fibrin - D-dimer - acute myocardial infarction

Full Text

References

References
1 Mak KH, Lee LH, Wong A. et al. Thrombin generation and fibrinolytic activities among patients receiving reduced-dose alteplase plus abciximab or undergoing direct angioplasty plus abciximab for acute myocardial infarction. Am J Cardiol 2002; 89: 930-6.
2 Merlini PA, Bauer KA, Oltrona L. et al. Thrombin generation and activity during thrombolysis and concomitant heparin therapy in patients with acute myocardial infarction. J Am Coll Cardiol 1995; 25: 203-9.
3 Nossel HL, Yudelman I, Canfield RE. et al. Measurement of fibrinopeptide A in human blood. J Clin Invest 1974; 54: 43-53.
4 Dardik BN, Shainoff JR. Kinetic characterization of a saturable pathway for rapid clearance of circulating fibrin monomer. Blood 1985; 65: 680-688.
5 Hamano A, Tanaka S, Takeda Y, Umeda M, Sakata Y. A novel monoclonal antibody to fibrin monomer and soluble fibrin for the detection of soluble fibrin in plasma. Clin Chim Acta 2002; 318: 25-32.
6 Dempfle CE, Zips S, Ergul H, Heene DL. The fibrin assay comparison trial (FACT): correlation of soluble fibrin assays with D-dimer. Thromb Haemost 2001; 86: 1204-9.
7 Ravanat C, Freund M, Mangin P. et al. GPV is a marker of in vivo platelet activation—study in a rat thrombosis model. Thromb Haemost 2000; 83: 327-33.
8 Azorsa DO, Moog S, Ravanat C. et al. Measurement of GPV released by activated platelets using a sensitive immunocapture ELISA—its use to follow platelet storage in transfusion. Thromb Haemost 1999; 81: 131-8.
9 Gaudron P, Kugler I, Hu K, Bauer W, Eilles C, Ertl G. Time course of cardiac structural, functional and electrical changes in asymptomatic patients after myocardial infarction: their inter-relation and prognostic impact. J Am Coll Cardiol 2001; 38: 33-40.
10 Becker U, Bartl K, Wahlefeld AW. A functional photometric assay for plasma fibrinogen. Thromb Res 1984; 35: 475-84.
11 Dempfle CE, Dollman M, Lill H, Puzzovio D, Dessauer A, Heene DL. Binding of a new monoclonal antibody against N-terminal hep-tapeptide of fibrin alpha-chain to fibrin polymerization site ‘A’: effects of fibrinogen and fibrinogen derivatives, and pretreatment of samples with NaSCN. Blood Coagul Fibrinolysis 1993; 4: 79-86.
12 Lill H, Spannagl M, Trauner A. et al. A new immunoassay for soluble fibrin enables a more sensitive detection of the activation state of blood coagulation in vivo. Blood Coagul Fibrinolysis 1993; 4: 97-102.
13 Kario K, Matsuo T, Kabayashi H. et al. Rapid quantitative evaluation of plasma D-dimer levels in thrombotic states using an automated latex photometric immunoassay. Thromb Res 1992; 66: 179-89.
14 Manten A, de Winter RJ, Minnema MC, ten Cate H, LiJmer JG, Adams R, Peters RJ. et al. Procoagulant and proinflammatory activity in acute coronary syndromes. Cardiovasc Res 1998; 40: 389-95.
15 Li YH, Teng JK, Tsai WC. et al. Prognostic significance of elevated hemostatic markers in patients with acute myocardial infarction. J Am Coll Cardiol 1999; 33: 1543-8.
16 Weitz JI, Leslie B, Hudoba M. Thrombin binds to soluble fibrin degradation products where it is protected from inhibition by heparin-antithrombin but susceptible to inactivation by antithrombin-independent inhibitors. Circulation 1998; 97: 544-52.
17 Eisenberg PR, Sherman LA, Schectman K, Perez J, Sobel BE, Jaffe AS. Fibrinopeptide A: a marker of acute coronary thrombosis. Circulation 1985; 71: 912-8.
18 Wilensky RL, Pyles JM, Fineberg N. Increased thrombin activity correlates with increased ischemic event rate after percutaneous transluminal coronary angioplasty: lack of efficacy of locally delivered urokinase. Am Heart J 1999; 138: 319-25.
19 Cantor WJ, Newby LK, Christenson RH. et al. Prognostic significance of elevated troponin I after percutaneous coronary intervention. J Am Coll Cardiol 2002; 39: 1738-44.
20 Aviles RJ, Askari AT, Lindahl B. et al. Troponin T levels in patients with acute coronary syndromes, with or without renal dysfunction. N Engl J Med 2002; 346: 2047-52.
21 Herrmann J, Von Birgelen C, Haude M. et al. Prognostic implication of cardiac troponin T increase following stent implantation. Heart 2002; 87: 549-53.
22 Ragosta M, Karve M, Brezynski D. et al. Effectiveness of heparin in preventing throm-bin generation and thrombin activity in patients undergoing coronary intervention. Am Heart J 1999; 137: 250-7.
23 Lee LV, Ewald GA, McKenzie CR, Eisenberg PR. The relationship of soluble fibrin and cross-linked fibrin degradation products to the clinical course of myocardial infarction. Arterioscler Thromb Vasc Biol 1997; 17: 628-33.
24 McCarron BI, Marder VJ, Francis CW. Reactivity of soluble fibrin assays with plasmic degradation products of fibrin and in patients receiving fibrinolytic therapy. Thromb Haemost 1999; 82: 1722-9.
25 Hetland O, Knudsen A, Dickstein K, Nilsen DW. Characteristics and prognostic impact of plasma fibrin monomer (soluble fibrin) in patients with coronary artery disease. Blood Coagul Fibrinolysis 2002; 13: 301-8.
26 Kontny F, Dempfle CE, Abildgaard U. Fibrin monomer antigen: a novel marker of mortality in acute myocardial infarction. Eur Heart J 1999; 20: 808-12.
27 Dempfle CE, Kontny F, Abildgaard U. Predictive value of coagulation markers concerning clinical outcome 90 days after anterior myocardial infarction. Thromb Haemost 1999; 81: 701-4.
28 Dempfle CE, Argiriou S, Kucher K. et al. Analysis of fibrin formation and proteolysis during intravenous administration of ancrod. Blood 2000; 96: 2793-802.
29 Dempfle CE, Zips S, Ergul H. et al. The Fibrin Assay Comparison Trial (FACT): evaluation of 23 quantitative D-dimer assays as basis for the development of D-dimer calibrators. FACT study group. Thromb Haemost 2001; 85: 671-8.
30 Blann AD, Lanza F, GalaJda P. et al. Increased platelet glycoprotein V levels in patients with coronary and peripheral atherosclerosis—the influence of aspirin and cigarette smoking. Thromb Haemost 2001; 86: 777-83.
31 Jaffe AS, Lee RG, Perez JE, Geltman EM, Wilner GD, Sobel BE. Lack of elevation of platelet factor IV in plasma from patients with myocardial infarction. J Am Coll Cardiol 1984; 4: 653-9.