The purpose of this study was to define the frequency and reversibility of abnormal fibrinolytic activity in patients with coronary artery disease and non-acute ischemic chest pain syndromes. Measurments of tissue plasminogen activate (t-PA), inhibitor of tissue plasminogen activation (IPA) and alpha 2-antiplasmin were made in 10 patients with refractory angina before and after long-term treatment using Ancrod, which is a snake vemon derivative possessing defibronogenating and indirect tPA properties. We found that most patients with severe refractory angina have abnormal fibronolytic activity either at rest or during exercise and that these abnormalities can be improved or normalized during Ancrod therapy. Moreover, Ancrod therapy also prolonged exercise capacity in most patients and reduced anginal symptoms. These preliminary observations suggest that primary or acquired deffects in fibrinolytic activity may play some role in ischemic chest pain syndromes and that such abnormalities can be improved with specific pharmaceutical agents having thrombolytic properties.
