Background: Production of oxygen free radicals, and activation of neutrophils and plasma complement contribute to myocardial reperfusion injury, but the role of coagulation has not been assessed.
Objective: To characterize tissue-factor-mediated generation of thrombin and its association with tissue injury during reperfusion from normothermic ischemia of isolated, Langendorf-perfused rabbit hearts.
Methods: Activation of coagulation was assessed by addition of 12% rabbit plasma and human fibrinogen to Krebs-Henseleit-buffer perfusate with measurement of levels of human fibrinopeptide A (hFPA) in the heart effluent as an index of thrombin-mediated formation of fibrin.
Study Objective: The purpose of this study was to determine the number of eligible prehospital thrombolytic candidates and to estimate the potential time saved if field thrombolysis had been initiated in a series of prehospital chest pain patients.
Design And Setting: Prehospital 12-lead ECGs were obtained by paramedics during initial evaluation of chest pain patients and stored in the computerized ECG. Prehospital 12-lead ECGs, prehospital charts, and hospital charts then were reviewed retrospectively for final hospital diagnosis, prehospital and emergency department times, and historical exclusion criteria for prehospital treatment with recombinant tissue-type plasminogen activator (r-TPA).