Molecular Markers of Thrombosis and Fibrinolysis in Patients with Chronic Thromboembolic Pulmonary Hypertension Norifumi Nakanishi 1 , Shingo Kyotani 1 , Toru Satoh 1 , Yoshiaki Okano 1 , Takeyoshi Kunieda 1 1Cardiac Division, Department of Internal Medicine, National Cardiovascular Center Keyword: 慢性肺血栓塞栓症 , 凝固—線溶系分子マーカー , 血栓溶解療法 , chronic thromboembolic pulmonary hypertension , molecular markers of thrombosis and fibrinolysis , thrombolytic therapy pp.731-736
Published Date 1996/7/15
DOI https://doi.org/10.11477/mf.1404901289
  • Abstract
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To evaluate the activity of the hemostatic and fibrinolytic system in 17 patients with chronic throm-boembolic pulmonary hypertension (CTEPH), we mea-sured the plasma concentration of thrombin-antithrom-bin III complex (TAT) and fibrinopeptide A (FPA) as molecular markers of ongoing thrombosis, plasmin-α2 plasmin inhibitor complex (PIC) and D-dimer as molec-ular markers of fibrinolysis at admission and during thrombolytic therapy. The plasma concentrations of TAT, FPA, PIC and D-dimer at admission were 6.6±7.5ng/ml, 4.1±2.8ng/ml, 0.9±0.7μg/ml, 221±176ng/ml,respectively. In about half of the CTEPH patients, the thrombotic and fibrinolytic system was slightly activat-ed. However, in the remaining half, the activity of the thrombotic and fibrinolytic system was not accentuated. Thrombolytic therapy using urokinase was carried out in 9 cases. In these patients. the PIC and D-dimer showed almost normal values before urokinase infusion. Although PIC increased markedly after urokinase infu-sion, the D-dimer showed no marked changed except in 3 cases. As the D-dimer is considered to be a good index for clot lvsis. these findings suggest that throm-bolytic therapy was ineffective in most patients with CTEPH when their molecular markers of fibrinolysis were within the normal range before thrombolytic ther-apy. The molecular markers of thrombosis and fi-brinolysis were good tools for examining the patho-physiology of CTEPH. and for evaluating the effectiveness of thrombolytic therapy.

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