Experimental Evaluation of Coronary Thrombodynamics and Effects of Pharmacological Interventions in Acute Coronary Syndromes : PATHOGENESIS AND MANAGEMENT OF IMPENDING MYOCARDIAL INFARCTION

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Intracoronary thrombodynamics in acute coronary syndromes was studied with an experimental canine model. An intracoronary thrombus was precipitated at the mock ruptured atheromatous plaque consisting of cholesterol and collagen. In 8 of 10 control models, acute myocardial infarction (AMI) was induced by intracoronary occlusive thrombus I h after the start of the experiment. Coronary blood flow decreased continuously (Type A, n=5) or cyclically (Type B, n=3) to end in AMI. Effects of pharmacological interventions to prevent AMI were also studied with the model. An intravenous bolus injection of a thromboxane synthetase inhibitor (RS-5186), heparin, a thrombin inhibitor (argatroban), and a thrombolytic agent (urokinase) was performed in 10 models for each drug. The incidence of AMI was significantly decreased to 3 of the 10 models injected with the thromboxane synthetase inhibitor and heparin (p< .05, each drug group vs. control). The preventive effect of argatroban was more potent and AMI occur-red in 2 of 10 models (p<0.01, argatroban vs control).