SELECTION OF PATIENTS FOR ANTICOAGULANT THERAPY IN ACUTE MYOCARDIAL INFARCTION*

1954 ◽  
Vol 228 (2) ◽  
pp. 133-139 ◽  
Author(s):  
HENRY I. RUSSEK ◽  
BURTON L. ZOHMAN
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Anticoagulant Therapy ◽  
Selection Of Patients ◽  
Selection Of

scholarly journals Early Diagnosis of Acute Myocardial Infarction: CK-MB and Myoglobin Compared

1993 ◽  
Vol 30 (5) ◽  
pp. 435-438 ◽  
Author(s):  
W S Kilpatrick ◽  
D Wosornu ◽  
J B McGuinness ◽  
A C A Glen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Care Unit ◽  
Rapid Diagnosis ◽  
Blood Samples ◽  
Care Utilisation ◽  
Creatine Kinase Mb ◽  
Coronary Care ◽  
Selection Of Patients ◽  
Selection Of

We have measured changes in plasma concentration of creatine kinase MB (CK-MB) and myoglobin in 50 patients admitted to the Coronary Care Unit with chest pain of presumed cardiac origin. Eight serial blood samples were obtained in the 6 h period following admission and both CK-MB and myoglobin concentrations were measured. We compared the performance of single values of both tests. Myoglobin concentration, in the coronary care population studied, proved to be as specific as CK-MB concentration (92–6% in both cases) but with sensitivity of 100% being achieved 1 · 5 h post admission rather than 4 h post admission in the case of CK-MB. On this evidence, measurement of plasma myoglobin could prove useful in the rapid diagnosis of myocardial infarction with consequent effects on optimal Coronary Care utilisation and selection of patients for thrombolytic therapy.

scholarly journals Early Diagnosis of Acute Myocardial Infarction by CK-MB Mass Measurements

1992 ◽  
Vol 29 (1) ◽  
pp. 43-47 ◽  
Author(s):  
P O Collinson ◽  
S B Rosalki ◽  
T Kuwana ◽  
H M Garratt ◽  
E M Ramhamadamy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Admission Diagnosis ◽  
Mass Measurements ◽  
Incremental Change ◽  
Cardiac Symptoms ◽  
Creatine Kinase Mb ◽  
Selection Of Patients ◽  
Selection Of

We have studied the changes in creatine kinase (CK) and creatine kinase MB (CK-MB) activity and concentration for the diagnosis of acute myocardial infarction in 73 patients admitted to the coronary care unit with cardiac symptoms of 12 h duration or less. Serial blood samples were obtained for an 8 h period following admission and CK, CK-MB activity and concentration measured. We compared the performance of single values at optimized diagnostic cut-offs and incremental change (log slope) for all three measurements. CK slope combined with CK-MB concentration measurements allowed accurate diagnosis at 4 h from admision. CK-MB concentration determination 8 h from admission (12–16 h from the onset of chest pain) was the most efficient single measurement. Rapid diagnostic categorization and possible selection of patients for thrombolysis in patients with an uncertain admission diagnosis is possible by these techniques.

scholarly journals Selection of patients for early discharge after acute myocardial infarction.

Heart ◽  
1974 ◽  
Vol 36 (6) ◽  
pp. 533-535 ◽  
Author(s):  
N C Chaturvedi ◽  
M J Walsh ◽  
A Evans ◽  
P Munro ◽  
D M Boyle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Discharge ◽  
Selection Of Patients ◽  
Selection Of

scholarly journals Review. Anticoagulant Therapy in Sepsis. The Importance of Timing

2017 ◽  
Vol 3 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Ecaterina Scarlatescu ◽  
Dana Tomescu ◽  
Sorin Stefan Arama
Keyword(s):  
Anticoagulant Therapy ◽  
Coagulation Activation ◽  
Proper Selection ◽  
Beneficial Effects ◽  
Patient Heterogeneity ◽  
The Difference ◽  
The Right ◽  
Harmful Effects ◽  
Selection Of Patients ◽  
Selection Of

Abstract Sepsis associated coagulopathy is due to the inflammation-induced activation of coagulation pathways concomitant with dysfunction of anticoagulant and fibrinolytic systems, leading to different degrees of haemostasis dysregulation. This response is initially beneficial, contributing to antimicrobial defence, but when control is lost coagulation activation leads to widespread microvascular thrombosis and subsequent organ failure. Large clinical trials of sepsis-related anticoagulant therapies failed to show survival benefits, but posthoc analysis of databases and several smaller studies showed beneficial effects of anticoagulants in subgroups of patients with early sepsis-induced disseminated intravascular coagulation. A reasonable explanation could be the difference in timing of anticoagulant therapy and patient heterogeneity associated with large trials. Proper selection of patients and adequate timing are required for treatment to be successful. The time when coagulation activation changes from advantageous to detrimental represents the right moment for the administration of coagulation-targeted therapy. In this way, the defence function of the haemostatic system is preserved, and the harmful effects of overwhelming coagulation activation are avoided.

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