PubMed · 13906968
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P HERZOG, A DRDOVA. 1961. In-V factor in CSSR.. https://doi.org/10.1111/j.1423-0410.1961.tb03218.x
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The lung vasculature bed has a unique fibrinolytic potential, which has not yet been completely elucidated. We investigated the effect of blood passage through the pulmonary circulation on the values of fibrinolytic parameters in plasma. Forty-seven patients (16 women, 31 men, mean age 54 years, range 21-67 years) who had undergone elective cardiac catheterization were included in the study. The blood samples were taken simultaneously from the right atrium and the left ventricle. The following fibrinolytic parameters were measured: tissue-type plasminogen (t-PA) antigen and activity, plasminogen activator inhibitor-1 (PAI-1) antigen and activity, and euglobulin clot lysis time (ECLT). No difference was found between the samples obtained from the right atrium and the left ventricle with respect to t-PA antigen: 8.1 (6.7-11.3) vs 8.4 (5.9-11.0) ng/ml; t-PA activity: 92 (5-680) vs 62 (32-696) IU/ml; PAI-1 antigen: 8.4 (5.5-14.3) vs 8.7 (6.2-13.1) ng/ml; and ECLT: 5.5 (4.1-9.1) vs 5.6 (4.1-8.5) 1 000/min. In contrast, PAI activity decreased significantly: 7.9 (5.8-10.3) vs 7.4 (6.0-10.4) IU/ml, P < 0.01. Patients with and without pulmonary hypertension did not differ in any of measured parameters, either in the right atrium or in the left ventricle. These results show that under basal conditions fibrinolytic activity which is not attributed to t-PA is elevated in lung vasculature. Further, basal fibrinolytic activity in the lungs is not influenced by pulmonary hypertension.
Platelet contamination in stored plasma may affect coagulation assays, including the endogenous thrombin potential (ETP), which has been proposed for the investigation of hyper- and hypo-coagulability. The current recommendation of filtering plasma before freezing cannot be always met. This study provides evidence that filtering frozen plasma after thawing, prior to testing, may help to eliminate the unwanted effect of residual platelets on the ETP. This may have important implications in future studies, as the ETP could be determined with plasma that have been collected without precautions relating to platelet contamination, as is the case for plasmas collected in epidemiological studies.
BACKGROUND: The use of laboratory coagulation tests in some fields of primary medicine is not well defined in available guidelines. In Italy, general practitioners tend to lack a thorough understanding of the utility of knowledge of coagulation inhibitors. METHODS: We reviewed the clinical conditions for which outpatients have been referred to our laboratory for antithrombin testing or for inherited thrombophilia tests panels over a 3-week period. Evidence-based guidelines were used to identify the appropriate requests. RESULTS: Numerous unnecessary tests were requested for both antithrombin and thrombophilia, particularly in obstetric and gynaecological situations in the setting of hormonal contraceptive treatment. CONCLUSIONS: Laboratory specialists must improve upon their communication with physicians in order to achieve an appropriate use of coagulation tests.