Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers
The association between severity of fibrinolysis, ascertained by rotational thromboelastometry to diagnose hyperfibrinolysis in patients with out-of-hospital cardiac arrest (OHCA), and conventional fibrinolysis markers (ie, tissue-plasminogen activator [t-PA], plasminogen, α 2 -plasmin inhibitor [α...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-06-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/1076029620933003 |
| _version_ | 1818268692285227008 |
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| author | Tomoyo Saito MD, PhD Mineji Hayakawa MD, PhD Yoshinori Honma MD Asumi Mizugaki MD Tomonao Yoshida MD Kenichi Katabami MD Takeshi Wada MD, PhD Kunihiko Maekawa MD |
| author_facet | Tomoyo Saito MD, PhD Mineji Hayakawa MD, PhD Yoshinori Honma MD Asumi Mizugaki MD Tomonao Yoshida MD Kenichi Katabami MD Takeshi Wada MD, PhD Kunihiko Maekawa MD |
| author_sort | Tomoyo Saito MD, PhD |
| collection | DOAJ |
| description | The association between severity of fibrinolysis, ascertained by rotational thromboelastometry to diagnose hyperfibrinolysis in patients with out-of-hospital cardiac arrest (OHCA), and conventional fibrinolysis markers (ie, tissue-plasminogen activator [t-PA], plasminogen, α 2 -plasmin inhibitor [α 2 -PI], and plasminogen activator inhibitor [PAI]) with key roles in the fibrinolytic system was investigated. This prospective observational study included 5 healthy volunteers and 35 patients with OHCA from the Hokkaido University Hospital. Blood samples were drawn immediately upon admission to the emergency department. Assessments of the extrinsic pathway using tissue factor activation (EXTEM) and of fibrinolysis by comparison with EXTEM after aprotinin addition (APTEM) were undertaken. Conventional coagulation and fibrinolysis markers were measured in the stored plasma samples. Significant hyperfibrinolysis observed in EXTEM disappeared in APTEM. Patients exhibited significantly higher levels of fibrinogen/fibrin degradation products, plasmin–α 2 -PI complex, and t-PA but lower levels of fibrinogen, plasminogen, and α 2 -PI than healthy controls. The PAI level was unchanged. Fibrinolytic parameters of EXTEM correlated with levels of lactate and conventional fibrinolysis markers, especially t-PA. Increased t-PA activity and decreased plasminogen and α 2 -PI significantly correlated with increased severity of fibrinolysis (hyperfibrinolysis). |
| first_indexed | 2024-12-12T20:42:32Z |
| format | Article |
| id | doaj.art-bc257bb4976946638f6566c371002b52 |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-12-12T20:42:32Z |
| publishDate | 2020-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-bc257bb4976946638f6566c371002b522022-12-22T00:12:40ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232020-06-012610.1177/1076029620933003Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis MarkersTomoyo Saito MD, PhD0Mineji Hayakawa MD, PhD1Yoshinori Honma MD2Asumi Mizugaki MD3Tomonao Yoshida MD4Kenichi Katabami MD5Takeshi Wada MD, PhD6Kunihiko Maekawa MD7 Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, JapanThe association between severity of fibrinolysis, ascertained by rotational thromboelastometry to diagnose hyperfibrinolysis in patients with out-of-hospital cardiac arrest (OHCA), and conventional fibrinolysis markers (ie, tissue-plasminogen activator [t-PA], plasminogen, α 2 -plasmin inhibitor [α 2 -PI], and plasminogen activator inhibitor [PAI]) with key roles in the fibrinolytic system was investigated. This prospective observational study included 5 healthy volunteers and 35 patients with OHCA from the Hokkaido University Hospital. Blood samples were drawn immediately upon admission to the emergency department. Assessments of the extrinsic pathway using tissue factor activation (EXTEM) and of fibrinolysis by comparison with EXTEM after aprotinin addition (APTEM) were undertaken. Conventional coagulation and fibrinolysis markers were measured in the stored plasma samples. Significant hyperfibrinolysis observed in EXTEM disappeared in APTEM. Patients exhibited significantly higher levels of fibrinogen/fibrin degradation products, plasmin–α 2 -PI complex, and t-PA but lower levels of fibrinogen, plasminogen, and α 2 -PI than healthy controls. The PAI level was unchanged. Fibrinolytic parameters of EXTEM correlated with levels of lactate and conventional fibrinolysis markers, especially t-PA. Increased t-PA activity and decreased plasminogen and α 2 -PI significantly correlated with increased severity of fibrinolysis (hyperfibrinolysis).https://doi.org/10.1177/1076029620933003 |
| spellingShingle | Tomoyo Saito MD, PhD Mineji Hayakawa MD, PhD Yoshinori Honma MD Asumi Mizugaki MD Tomonao Yoshida MD Kenichi Katabami MD Takeshi Wada MD, PhD Kunihiko Maekawa MD Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers Clinical and Applied Thrombosis/Hemostasis |
| title | Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers |
| title_full | Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers |
| title_fullStr | Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers |
| title_full_unstemmed | Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers |
| title_short | Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers |
| title_sort | relationship between severity of fibrinolysis based on rotational thromboelastometry and conventional fibrinolysis markers |
| url | https://doi.org/10.1177/1076029620933003 |
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