[Intravenous thrombolysis in XXXX . Influence of the quality of the anticoagulation on the early recurrence rate of @entity951 or @entity1188 ].

@entity1 @entity137 @entity64 @entity2974 @entity951 @entity1188 @entity2142 @entity583
In this retrospective study the data of 70 @entity1 treated with streptokinase in the acute phase of @entity583 were reviewed in search of a possible relation between recurrent @entity137 and degree of anticoagulation. All @entity1 had received a 30 mn infusion of streptokinase 1.500.000 units within a mean 175 mn period from the initial symptoms. They were followed up clinically (signs of @entity951 or @entity1188 ), angiographically (coronary arteriography within 5.5 days on average) and biochemically (daily measurements of @entity2974 values and blood fibrinogen concentrations). Fifteen recurrent @entity137 (21.4 p. 100), including 6 attacks of @entity951 and 9 @entity583 , were observed. Angiography showed that the artery responsible for the initial @entity1188 was occluded in 23.6 p. 100 (13/55) of @entity1 without recurrent @entity64 . This figure rose to 46.6 p. 100 in @entity1 who suffered a new @entity2142 (7/15; NS) and up to 77 p. 100 in those who developed a new @entity583 (7/9; p less than 0.01). Biochemical data showed that 13 recurrent @entity64 occurred when the APTT values were lower than 1.5 (176 measurements), as against 2 when these values were higher than 1.5 (359 measurements) (p less than 0.01). These two recurrent @entity64 took place when fibrinogen concentrations abruptly rose above 1 g/litre. These results demonstrate that poor quality anticoagulation is responsible for the occurrence of recurrent @entity137 within days of thrombolysis for acute @entity583 . They prompt the authors to recommend anticoagulation with heparin started at an early stage and carefully adjusted by means of repeated biochemical essays.
