High F1.2 fragment of prothrombin, thrombin-antithrombin III complex (TAT) and soluble fibrin plasma levels demonstrate hypercoagulability induced during loco-regional thrombolytic therapy with rt-PA.
In order to investigate the coagulation and fibrinolysis state in arterial peripheral thrombosis and thrombolysis, we studied 33 consecutive patients (mean age = 65, range: 28-88), 25 males and 8 females diagnosed of acute or subacute lower limb arterial thrombosis, treated with an intrathrombus infusion of rt-PA (0.1 mg/Kg/h) for three hours. Plasma levels of antithrombin III (AT-III), protein C (PC), plasminogen (Pg) and alpha 2-antiplasmin (AP), total and free protein S (PS), thrombin-antithrombin III complex (TAT), F1.2 fragment of prothrombin (F1.2), fibrinogen (Fg), soluble fibrin monomers (FM), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), total fibrinogen/fibrin degradation products (TDP) and D dimer (DD) were determined prior to the therapeutic regime, at the end of the treatment, and 24 hours later. Levels of AT-III and protein C were somewhat low during the complete study. There was an increase in t-PA, TDP and D Dimer and a decrease of fibrinogen, alpha 2-antiplasmin and plasminogen at 3 hours. An elevation of TAT, fibrin monomers and F1.2 levels was found at three hours. A positive correlation between TAT and F1.2 was observed (r = 0.57, p < 0.05). There was also a positive correlation between soluble fibrin and TAT (r = 0.59, p < 0.05) and with F1.2 (r = 0.56. p < 0.05). These latter facts reflect an hypercoagulable situation induced during loco-regional thrombolytic therapy.
Garcia-Avello
A
A
Hematology Dept, Hospital Ramón y Cajal, Madrid, Spain.
Garcia-Frade
L J
LJ
Gandarias
C
C
Ocaña
J
J
Cancelas
J A
JA
Lasso
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000032:analysis*; D001778:Blood Coagulation Disorders / Q000097:blood / Q000139:chemically induced*; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D005337:Fibrin / Q000032:analysis*; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis*; D010447:Peptide Hydrolases / Q000032:analysis*; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011516:Prothrombin / Q000032:analysis*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy*
D001798:Blood Proteins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C046193:antithrombin III-protease complex; C045879:prothrombin fragment 1.2; D000990:Antithrombin III; D011516:Prothrombin; D005337:Fibrin; D010447:Peptide Hydrolases; D010960:Plasminogen Activators