FAILURE OF THROMBOLYTIC THERAPY IN PATIENTS WITH MYOCARDIAL-INFARCTION IS ASSOCIATED WITH HIGH PLASMA-LEVELS OF FACTOR-VII ANTIGEN

Thrombolytic therapy in acute myocardial infarction fails to re-establ ish coronary blood flow in a significant number of patients. One reaso n for this may be haemostatic imbalance. We investigated whether coagu lation factor VII antigen (FVIIag), fibrinogen and protein C were rela ted to reperfusion. Plasma from 45 patients was drawn before treatment and reperfusion assessed by means of continuous, on-line, vector-EGG analysis. Among the 17 patients with no reperfusion, FVIIag levels wer e significantly higher than among the 28 with signs of reperfusion (56 0 vs. 410 mu g/l median: p = 0.006). Protein C levels where higher in the group with successful reperfusion (1.10 vs. 1.01 U/ml median. p = 0.03), whereas no difference was seen in fibrinogen levels. The findin gs were not influenced by plasma-triglycerides, body-mass index, age o r time between onset of chest pain and thrombolytic therapy. The resul ts suggest that FVII is of importance for the formation as well as res olution of coronary clots.