Abstract
OBJECTIVE: To determine the time course of platelet alpha granule release in patients with acute myocardial infarction treated with streptokinase. DESIGN: A prospective study. SETTING: Coronary care unit. PATIENTS: Nine with myocardial infarction treated with both streptokinase and aspirin, and nine with acute chest pain but without myocardial infarction, who were treated with aspirin only. METHODS: All patients received 250 mg aspirin on admission and 150 mg once daily thereafter. All patients who fulfilled the indications for streptokinase received 1.5 megaunits, in a single infusion. After the initial medication, serial measurements of plasma beta thromboglobulin and plasma platelet factor 4 were performed at fixed intervals after the onset of chest pain. The primary endpoint sought was the peak value of beta thromboglobulin and platelet factor 4 in each individual. RESULTS: The median peak plasma beta thromboglobulin in the infarction group was substantially higher than in those without infarction, at 37 (range 12 to 210) v 15 (9 to 36) mg/litre, P < 0.01. The corresponding values for plasma platelet factor 4 were 4.6 (2.4 to 60.0) v 2.2 (< 2 to 8.5) mg/litre, P < 0.01. Increased values were seen only within the first 12 h after onset of chest pain, and after 12 h there was no difference between the patients with myocardial infarction and those without. Aspirin treatment did not abolish alpha granule release. CONCLUSIONS: In patients with acute myocardial infarction treated with streptokinase the content of the alpha granules is released within the first 12 h after the onset of chest pain. Aspirin apparently does not abolish this release.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bertolino G., Noris P., Previtali M., Gamba G., Ferrario M., Montani N., Balduini C. L. Platelet function after in vivo and in vitro treatment with thrombolytic agents. Am J Cardiol. 1992 Feb 15;69(5):457–461. doi: 10.1016/0002-9149(92)90985-8. [DOI] [PubMed] [Google Scholar]
- Carrieri P., Orefice G., Indaco A. No effect of acetylsalicylic acid on B-thromboglobulin and platelet factor 4 plasma levels in patients with transient ischaemic attacks. Stroke. 1986 Nov-Dec;17(6):1153–1155. doi: 10.1161/01.str.17.6.1153. [DOI] [PubMed] [Google Scholar]
- Ffrench P., McGregor J. L., Berruyer M., Belleville J., Touboul P., Dawes J., Dechavanne M. Comparative evaluation of plasma thrombospondin beta-thromboglobulin and platelet factor 4 in acute myocardial infarction. Thromb Res. 1985 Sep 1;39(5):619–624. doi: 10.1016/0049-3848(85)90242-7. [DOI] [PubMed] [Google Scholar]
- Gallino A., Haeberli A., Hess T., Mombelli G., Straub P. W. Fibrin formation and platelet aggregation in patients with acute myocardial infarction: effects of intravenous and subcutaneous low-dose heparin. Am Heart J. 1986 Aug;112(2):285–290. doi: 10.1016/0002-8703(86)90263-2. [DOI] [PubMed] [Google Scholar]
- Ganz W., Geft I., Shah P. K., Lew A. S., Rodriguez L., Weiss T., Maddahi J., Berman D. S., Charuzi Y., Swan H. J. Intravenous streptokinase in evolving acute myocardial infarction. Am J Cardiol. 1984 May 1;53(9):1209–1216. doi: 10.1016/0002-9149(84)90066-3. [DOI] [PubMed] [Google Scholar]
- Harrison D. G., Ferguson D. W., Collins S. M., Skorton D. J., Ericksen E. E., Kioschos J. M., Marcus M. L., White C. W. Rethrombosis after reperfusion with streptokinase: importance of geometry of residual lesions. Circulation. 1984 May;69(5):991–999. doi: 10.1161/01.cir.69.5.991. [DOI] [PubMed] [Google Scholar]
- Jaffe A. S., Lee R. G., Perez J. E., Geltman E. M., Wilner G. D., Sobel B. E. Lack of elevation of platelet factor IV in plasma from patients with myocardial infarction. J Am Coll Cardiol. 1984 Oct;4(4):653–659. doi: 10.1016/s0735-1097(84)80389-7. [DOI] [PubMed] [Google Scholar]
- Jang I. K., Vanhaecke J., De Geest H., Verstraete M., Collen D., Van de Werf F. Coronary thrombolysis with recombinant tissue-type plasminogen activator: patency rate and regional wall motion after 3 months. J Am Coll Cardiol. 1986 Dec;8(6):1455–1460. doi: 10.1016/s0735-1097(86)80323-0. [DOI] [PubMed] [Google Scholar]
- Kaplan K. L., Owen J. Plasma levels of beta-thromboglobulin and platelet factor 4 as indices of platelet activation in vivo. Blood. 1981 Feb;57(2):199–202. [PubMed] [Google Scholar]
- Kaplan K. L., Owen J. Plasma levels of platelet secretory proteins. Crit Rev Oncol Hematol. 1986;5(3):235–255. doi: 10.1016/s1040-8428(86)80040-3. [DOI] [PubMed] [Google Scholar]
- Seitz R., Leising H., Liebermann A., Rohner I., Gerdes H., Egbring R. Possible interaction of platelets and adrenaline in the early phase of myocardial infarction. Res Exp Med (Berl) 1987;187(5):385–393. doi: 10.1007/BF01855665. [DOI] [PubMed] [Google Scholar]
- Sylvén C., Karlberg K. E., Chen J., Hagerman I., Egberg N., Bergström K. Enhanced platelet function in acute myocardial infarction is attenuated by streptokinase treatment. J Intern Med. 1992 Jun;231(6):595–600. doi: 10.1111/j.1365-2796.1992.tb01245.x. [DOI] [PubMed] [Google Scholar]
- Udvardy M., Harsfalvi J., Boda Z., Rak K. Beta thromboglobulin and increased platelet activation after streptokinase treatment of acute myocardial infarction. Am J Cardiol. 1992 Sep 15;70(7):837–838. doi: 10.1016/0002-9149(92)90581-i. [DOI] [PubMed] [Google Scholar]
