title: Fibrinolysis and the risk of venous and arterial thrombosis.
abstract: OBJECTIVE
  The fibrinolytic system is often regarded as just an innocent bystander in the pathogenesis of venous and arterial thrombosis, while (hyper)coagulation as a risk factor has been studied extensively. In this review, we evaluated studies that investigated the association between fibrinolysis and thrombosis.
  
  
  RESULTS
  There is some evidence for an association between impaired overall fibrinolytic activity and increased risk of venous or arterial thrombosis. Plasminogen levels were found not to be related to thrombosis. Plasma levels of tissue-type plasminogen activator were related to arterial thrombosis in a number of studies but not to venous thrombosis. Thrombin activatable fibrinolysis inhibitor levels appeared to be associated with venous thrombosis. Studies on the association between thrombin activatable fibrinolysis inhibitor or plasminogen activator inhibitor-1 and arterial thrombosis had conflicting results.
  
  
  CONCLUSIONS
  Current evidence on an association between fibrinolysis and thrombosis is inconclusive. Although overall assays point to an association, not all individual factors have an association with thrombosis. Most importantly, plasminogen deficiency is not related to thrombosis, which suggests that the fibrinolytic system as a whole is unimportant in the occurrence of thrombosis. Certain components of the fibrinolytic system, however, appear to be involved in processes unrelated to fibrin degradation but related to other processes important in the development of thrombosis.
authors.affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Mirjam E
authors.initials: ME
authors.lastname: Meltzer
authors.forename: Carine J M
authors.initials: CJ
authors.lastname: Doggen
authors.forename: Philip G
authors.initials: PG
authors.lastname: de Groot
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: Ton
authors.initials: T
authors.lastname: Lisman
mesh_terms: D001157:Arterial Occlusive Diseases / Q000209:etiology; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D012306:Risk; D013927:Thrombosis / Q000209:etiology*; D010959:Tissue Plasminogen Activator; D020246:Venous Thrombosis / Q000209:etiology
chemical_list: D010959:Tissue Plasminogen Activator