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Thromb Haemost 1993; 70(06): 0998-1004
DOI: 10.1055/s-0038-1649714
Original Article
Fibrinolysis
Schattauer GmbH Stuttgart

Plasminogen Depletion during Streptokinase Treatment or Two-Chain Urokinase Incubation Correlates with Decreased Clot Lysability Ex Vivo and In Vitro

Páll T Önundarson
1   The Department of Hematology, Landspítalinn University Hospital, Reykjavik, Iceland
,
H Magnús Haraldsson
1   The Department of Hematology, Landspítalinn University Hospital, Reykjavik, Iceland
,
Lena Bergmann
1   The Department of Hematology, Landspítalinn University Hospital, Reykjavik, Iceland
,
Charles W Francis
2   The Hematology Unit, Department of Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA
,
Victor J Marder
2   The Hematology Unit, Department of Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA
› Author Affiliations
Further Information

Publication History

Received 28 April 1993

Accepted after revision 01 July 1993

Publication Date:
06 July 2018 (online)

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Summary

The relationship between lytic state variables and ex vivo clot lysability was investigated in blood drawn from patients during streptokinase administration for acute myocardial infarction. A lytic state was already evident after 5 min of treatment and after 20 min the plasminogen concentration had decreased to 24%, antiplasmin to 7% and fibrinogen 0.2 g/1. Lysis of radiolabeled retracted clots in the patient plasmas decreased from 37 ± 8% after 5 min to 21 ± 8% at 10 min and was significantly lower (8 ± 9%, p <0.005) in samples drawn at 20, 40 and 80 min. Clot lysability correlated positively with the plasminogen concentration (r = 0.78, p = 0.003), but not with plasmin activity. Suspension of radiolabeled clots in normal plasma pre-exposed to 250 U/ml two-chain urokinase for varying time to induce an in vitro lytic state was also associated with decreasing clot lysability in direct proportion with the duration of prior plasma exposure to urokinase. The decreased lysability correlated with the time-dependent reduction in plasminogen concentration (r = 0.88, p <0.0005). Thus, clot lysability decreases in conjunction with the development of the lytic state and the associated plasminogen depletion. The lytic state may therefore limit reperfusion during thrombolytic treatment.

 

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