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Quantitation of fragment X formation during thrombolytic therapy with streptokinase and tissue plasminogen activator.

Abstract
We have determined the extent of fragment X formation during thrombolytic therapy by integration over time of the plasma fibrinopeptide B beta 1-42 concentration. This peptide is quantitatively released when fragment X is formed by plasmin action on fibrinogen or fibrin I. In response to streptokinase (SK) and rt-PA, 264 +/- 54 and 95 +/- 12 mg/dl respectively of fibrinogen was converted to fragment X. By immunoblotting, fragment X was demonstrated as early as 5 min after SK and 30 min after rt-PA, and was still evident 24 h after treatment. Patients treated with SK showed extensive further plasmin degradation of fragment X to fragments Y and D. Thus fragment X concentrations tend to be more similar in the two groups than would be expected from the extent of fibrinogen breakdown. Fragment X forms clots, but these have lower tensile strength and are more susceptible to further plasmin lysis than clots of fibrin. Thus the similar bleeding observed in the two treatment groups might be a reflection of their similar plasma fragment X concentrations.
AuthorsJ Owen, K D Friedman, B A Grossman, C Wilkins, A D Berke, E R Powers
JournalThe Journal of clinical investigation (J Clin Invest) Vol. 79 Issue 6 Pg. 1642-7 (Jun 1987) ISSN: 0021-9738 [Print] United States
PMID2953761 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Fibrin Fibrinogen Degradation Products
  • Fibrinolytic Agents
  • Recombinant Proteins
  • fibrinogen fragment X
  • Fibrinopeptide B
  • Streptokinase
  • Tissue Plasminogen Activator
  • Fibrinolysin
Topics
  • Fibrin Fibrinogen Degradation Products (biosynthesis)
  • Fibrinolysin (metabolism)
  • Fibrinolytic Agents (therapeutic use)
  • Fibrinopeptide B (metabolism)
  • Hemorrhagic Disorders (prevention & control)
  • Humans
  • Myocardial Infarction (drug therapy)
  • Recombinant Proteins (therapeutic use)
  • Streptokinase (therapeutic use)
  • Tissue Plasminogen Activator (therapeutic use)

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