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- Title
Monitoring of Plasmin and Plasminogen Activator Activity in Blood of Patients under Fibrinolytic Treatment by Reteplase.
- Authors
Stief, T. W.; Richter, A.; Bünder, R.; Maisch, B.; Renz, H.
- Abstract
There are no reliable data on plasmin or plasminogen activator (PA) activities in blood of patients receiving fibrinolytic treatment. This is due to continuing in vitro action of PA after blood withdrawal. These artefactual changes of PA or plasmin activities have been prevented by arginine stabilization of blood samples of myocardial infarction patients treated with plasminogen activators. Twelve patients with myocardial infarction were treated with reteplase 2 x 10,000,000 units in bolus application; one patient was treated with 100 mg t-PA in continuous infusion. Blood was immediately stabilized with EDTA and arginine, The plasma was analyzed with newly developed assays for plasmin and PA. Maximal plasmin activities in blood were obtained at 40 to 60 minutes reteplase treatment time (0.1-0.6 U/mL = approximately 0.05-0.3 µmol/L plasmin). The 50% clearance rate for plasmatic Pli was greater than 30 minutes. The plasmatic reteplase concentration peaked at approximately 2000 U/mL after the first bolus infusion and at approximately 1500-3500 U/mL after the second bolus infusion. Reteplase was cleared to 50% within less than 30 minutes, also with great inter-individual variation. Arginine stabilization of blood allows reliable determinations of activities of plasmin and PA in blood of patients under fibrinolytic treatment: substantial plasmin activities occur in patients treated by reteplase, Therapeutic thrombolysis might be improved, imitating the physiologic cellular thrombolysis: i.e., polymorphonuclear phagocytes (PMN) that can be activated by singlet oxygen (¹O2). PMN might be superior to PA in selective lysis of pathologic thrombi.
- Subjects
PLASMIN; PLASMINOGEN activators; BLOOD diseases; FIBRINOLYSIS; THROMBOLYTIC therapy
- Publication
Clinical & Applied Thrombosis/Hemostasis, 2006, Vol 12, Issue 2, p213
- ISSN
1076-0296
- Publication type
Article
- DOI
10.1177/107602960601200210