Abstract:
BACKGROUND:The extent and mechanism of the antithrombotic properties of fibrin-selective and non-fibrin-selective thrombolytic agents have not yet been established. METHODS AND RESULTS:The antithrombotic, thrombolytic, fibrinogenolytic, and pharmacokinetic properties of the following substances were determined in hamsters in the absence of conjunctive anticoagulant or antiplatelet therapy: recombinant tissue-type plasminogen activator (rTPA), recombinant single-chain urokinase-type plasminogen activator (rscu-PA), two-chain urokinase-type plasminogen activator (UK), with a rTPA deletion mutant lacking amino acids 6 to 173 and a mutation N184E (K2Pt), a rTPA/rscu-PA chimeric plasminogen activator consisting of amino acids 1 to 3 and 87 to 274 of rTPA and amino acids 138 to 411 of rscu-PA (K1K2Pu), streptokinase (SK), and recombinant staphylokinase (STAR). The anti-thrombotic effect, defined as the intravenous dose required to reduce mural thrombus formation to 50% in a platelet-mediated femoral vein thrombosis model in the hamster, was 6 +/- 1, 5 +/- 2, 1 +/- 0.05, 2.5 +/- 0.2, 0.02 +/- 0.002, 1 +/- 0.09, and 2 +/- 0.3 mg/kg (mean +/- SEM), respectively. The amounts, given as intravenous infusion over 60 minutes that induced 50% clot lysis in a hamster pulmonary embolism model, were 0.18 +/- 0.03, 1.1 +/- 0.05, 0.9 +/- 0.13, 0.34 +/- 0.03, 0.04 +/- 0.003, 0.05 +/- 0.005, and 0.04 +/- 0.001 mg/kg, respectively, indicating that for most thrombolytic agents the antithrombotic dose is much higher than their thrombolytic dose. The fibrinogen levels, measured 40 minutes after bolus injection, were reduced to 50% of baseline with 3.1 +/- 0.2, 2.5 +/- 0.3, 1.2 +/- 0.08, 2.0 +/- 0.14, 1.7 +/- 0.65, 0.54 +/- 0.03, and 1.2 +/- 0.11 mg/kg, respectively. Mean residence times following intravenous bolus injection were: 18 +/- 1, 14 +/- 1, 100 +/- 10, 80 +/- 2, 20 +/- 3, and 34 +/- 5 minutes for rTPA, rscu-PA, K2Pt, K1K2Pu, SK, and STAR, respectively. Regression analysis revealed a significant correlation of the antithrombotic effect with the fibrinogen breakdown (P = .006) but not with the thrombolytic potency or with the mean residence time. CONCLUSIONS:These observations support the hypothesis that thrombolytic therapy with fibrinogen-sparing agents requires the conjunctive use of anticoagulant and/or antiplatelet agents.
journal_name
Circulationjournal_title
Circulationauthors
Stassen JM,Nyström A,Hoylaerts M,Collen Ddoi
10.1161/01.cir.91.5.1330subject
Has Abstractpub_date
1995-03-01 00:00:00pages
1330-5issue
5eissn
0009-7322issn
1524-4539journal_volume
91pub_type
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