Abstract
Acute coronary occlusion is a life-threatening complication of percutaneous transluminal coronary angioplasty (PTCA). Many recent studies have shown that the rate of acute occlusion after PTCA ranges from 4% to 8%(1,2). It may be caused by several mechanisms, and the formation of acute coronary thrombus at the dilated site appears to be one of the most important events(3,4). Sakamoto et al. have reported that marked thrombin generation was induced by PTCA despite pretreatment with a standard aspirin and heparin regimen. This thrombin generation was blocked by a potent synthetic thrombin inhibitor, argatroban, rather than by ordinary heparin(5). These findings suggest that heparin failed to prevent thrombin generation in situ, while argatroban did it after PTCA. However, heparin is unable to inhibit local thrombin generation at the site of PTCA. The purpose of the present study is to assess whether adjunctive antithrombotic treatment with argatroban, in combination with repeated dilation. is an effective therapeutic strategy for the management of acute coronary occlusion.
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