Thrombin generation and thrombin-antithrombin complex formation in patients with ischemic heart disease: diagnostic importance and impact of thrombolysis

ABSTRACT

50 patients with ischemic heart disease were included in the study. 20 patients with stable angina pectoris formed group I. Group II was formed of 10 patients suffering from unstable angina, and group III included 20 patients with documented transmural acute myocardial infarction. Group II and III patients were studied at presentation, before the administration of anticoagulants or thrombolytic therapy. Patients with diabetes, end stage renal disease or severe hepatic impairment were not included in the study. Ten normal healthy age-sex matched volunteers served as controls. Patients and controls were thoroughly clinically examined and subjected to routine electrocardiography to Document the diagnosis and cardiac enzymes [CPK, LDH, SGOT] were estimated for groups II and III patients. Patients and controls were subjected to routine coagulation studies [PT and PTT] and the assay of thrombin-antithrombin III complex [TAT] using an ELISA technique [Enzygnost TAT], Behring. TAT level was reassayed in 15 of group III patients 3 hours after the administration of 1.5 million units of streptokinase and before the start of heparin therapy