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Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers

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Title: Relationship Between Severity of Fibrinolysis Based on Rotational Thromboelastometry and Conventional Fibrinolysis Markers
Authors: Saito, Tomoyo Browse this author
Hayakawa, Mineji Browse this author →KAKEN DB
Honma, Yoshinori Browse this author
Mizugaki, Asumi Browse this author →KAKEN DB
Yoshida, Tomonao Browse this author →KAKEN DB
Katabami, Kenichi Browse this author
Wada, Takeshi Browse this author →KAKEN DB
Maekawa, Kunihiko Browse this author
Keywords: hyperfibrinolysis
out-of-hospital cardiac arrest
rotational thromboelastometry
tissue plasminogen activator
alpha(2)-plasmin inhibitor
Issue Date: 15-Jun-2020
Publisher: SAGE Publications
Journal Title: Clinical and applied thrombosis/hemostasis
Volume: 26
Start Page: UNSP 1076029620933003
Publisher DOI: 10.1177/1076029620933003
Abstract: 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, alpha(2)-plasmin inhibitor [alpha(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-alpha(2)-PI complex, and t-PA but lower levels of fibrinogen, plasminogen, and alpha(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 alpha(2)-PI significantly correlated with increased severity of fibrinolysis (hyperfibrinolysis).
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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