title: The susceptibility of plasma to activation of fibrinolysis.
abstract: The susceptibility of blood to fibrinolytic activation is an important parameter to predict the possible clinical outcome of thrombolysis in routine hospital practice. This paper describes a rapid method which is based on the integrated plasmin activity of a sample and which therefore does not require standardization of different fibrinolytic factors, such as plasminogen activator inhibitor type 1. Plasma is incubated with either streptokinase, urokinase (u-PA), tissue plasminogen activator (t-PA) or plasminogen streptokinase activator complex (PSAC) at room temperature. This is followed by addition of KCl, the chromogenic plasmin substrate S-2251 and chloramine T. As a blank, KCl is added before the enzyme. The incubation time is shortened three-fold at 37 degrees C. The highest fibrinolytic activity, with the smallest standard deviation, was obtained with streptokinase. When the lowest activity measured was defined as 100%, the highest activities were 273%, 297%, 344% and 961% for streptokinase, urokinase, t-PA and APSAC respectively. The susceptibility to urokinase correlated with that of t-PA. Patients reacted differently to the different plasminogen activators. Therefore, the method allows the appropriate agent and amount to be chosen before thrombolysis is started.
authors.affiliation: Thrombosis and Haemostasis Section, University Hospital of Seville, Spain.
authors.forename: T W
authors.initials: TW
authors.lastname: Stief
mesh_terms: D001774:Blood Chemical Analysis; D002700:Chloramines / Q000494:pharmacology; D005341:Fibrinolysin / Q000032:analysis* / Q000037:antagonists & inhibitors; D005342:Fibrinolysis / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000032:analysis*; D006801:Humans; D009097:Multienzyme Complexes / Q000032:analysis; D010960:Plasminogen Activators / Q000494:pharmacology; D013300:Streptokinase / Q000494:pharmacology
chemical_list: D002700:Chloramines; D005343:Fibrinolytic Agents; D009097:Multienzyme Complexes; D013300:Streptokinase; D010960:Plasminogen Activators; D005341:Fibrinolysin