Two hundred and twenty patients admitted to an acute coronary care unit were studied by serial plasma fibrinogen chromatography; 110 of these patients had documented acute myocardial infarction. Statistically significant increases in high molecular weight fibrin(ogen) complexes (HMWFC) were noted within 24 hours of disease onset and a further increase (p < 0.001) occurred within 48 hours in 43 patients who did not receive anticoagulant therapy. Plasma HMWFC usually returned to near normal values 12-20 days after disease onset.Sixty-seven additional patients received conventionally administered anticoagulant therapy, 10 initial heparin only, 33 heparin plus warfarin and 24 warfarin alone. plasma fibrinogen chromatographic findings in the anticoagulant treated patients did not differ significantly (p > 0.1) from those of the control untreated group over the first five days of illness. Minor differences were evident in the comparison of the 5-10 day findings in those receiving long-term warfarin therapy.Our findings demonstrate that patients with acute myocardial infarction develop a coagulopathy secondary to increased fibrin deposistion, presumably occurring at the infarct site. Since conventional anticoagulant therapy fails to control this phenomenon, the influence of fibrin deposition at the infarct site on disease outcome remains uncertain.
The Influence of Anticoagulant Treatment on Blood Coagulation System Findings in Patients with Acute Myocardial Infarction
