Plasmin-α2-antiplasmin complexes (plasmin—plasmin inhibitor complexes)

Hattey, E.; Haumer, Markus; Griffiths, M. R.; Carroll, Veronica A.; Binder, Bernd R.

doi:10.1007/978-94-011-4722-4_29

Cited by 2 publications

(3 citation statements)

References 37 publications

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“…27 PAP antigen levels were significantly higher in the dextran-treated patients 24 hours after operation compared with preoperative levels (13.59 Ϯ 3.3 g/mL vs 6.21 Ϯ 2.1 g/mL; P ϭ .043), indicating a rise in plasmin activity that was not seen in the saline group (Fig 2, B). Levels of PAI-1 antigen and activity increased significantly in both groups during the 24 hours studied (P Յ .02), but this rise in activity was significantly greater in the dextran group, reaching 38.16 U/mL compared with 22.75 U/mL PAI-1 activity in the saline group (P ϭ .037; Fig 2, C and D).…”

Section: Effects Of Dextran Infusion On Thrombus Formed In Vitromentioning

confidence: 56%

“…However, there was good indirect evidence of the effects of an elevation in tPA, indicated by the rise in plasmin-antiplasmin complexes, which are a marker of a previous rise in plasmin. 27 Because these complexes have a longer plasma half-life than tPA, 40 they were more readily detectable. Although this observation, and the significant increased levels of PAI-1 antigen, would seem to contradict the findings of Eriksson and Saldeen, 19 who saw a rise in tPA and a fall in PAI-1 in patients receiving dextran-70 during surgery, the timing of the samples differed from the present study.…”

Section: Discussionmentioning

confidence: 99%

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The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo

Jones

Payne

Hayes

et al. 2008

Journal of Vascular Surgery

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These data are consistent with a rise in plasmin due to dextran blockade of tPA uptake in vivo, leading to enhanced fibrinolysis, cleavage of vWF and of the platelet protease-activated receptor-1 (PAR-1) thrombin receptor. This suggests that dextran exerts a combined therapeutic effect, enhancing endogenous fibrinolysis, whilst also reducing platelet adhesion to vWF and platelet activation by thrombin. The proven antithrombotic efficacy of low-dose dextran in carotid surgery may be applicable to wider therapeutic use.

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Section: Effects Of Dextran Infusion On Thrombus Formed In Vitromentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo

Jones

Payne

Hayes

et al. 2008

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…24 The presence of plasmin-antiplasmin complexes (PAP) in the circulation is accepted as evidence that plasminogen is activated by tPA and converted to plasmin. 25 In a study of Jones et al, it was shown that PAP antigen levels were significantly higher after 24 h in patients treated with dextran. As a result of dextran 40 infusion, it was determined that the fibrinolysis rate was increased 13 times even after 1 h 26 In addition, the dextran infusion increases the plasma volume.…”

Section: Discussionmentioning

confidence: 96%

The usage and outcomes of dextran in the treatment of acute deep venous thrombosis

2021

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Objectives In this study, we retrospectively compared the outcomes of patients with acute deep vein thrombosis treated with dextran 40 infusion and unfractionated heparin with those of patients treated with unfractionated heparin alone. Methods We evaluated 104 patients with the diagnosis of acute deep vein thrombosis. The pain complaints of the patients at the time of admission and the pain complaints in the calf with dorsiflexion of the foot were evaluated with the visual analogue pain scale, and the calf diameter of affected limbs was measured. Fifty five patients had dextran 40 infusion and unfractionated heparin treatment concomitantly (Group HD), while 49 patients had unfractionated heparin treatment (Group H). Heparin dose was adjusted to obtain 1.5- to 2.5-fold of normal activated partial thromboplastin time in both groups. Oral anticoagulant, warfarin sodium, was administered in the first day and resumed. Unfractionated heparin infusion therapy was resumed until international normalized ratio values of 2–2.5 were obtained. Dextran 40 infusion therapy was administered for 3 days. Calf diameters, current pain, and calf pain at foot dorsiflexion were recorded at 48 h and 72 h. 65 patients were distal, and 39 patients were proximal and popliteal acute DVT. None of the patients had phlegmasia. All were acute DVT. Results At 48 and 72 h of therapy, it was determined that the decrease of the calf diameter and the pain were more significant both at 48th and 72nd hours in the Group HD. The calf circumference change, especially at 72 h, was 2.58 ± 0.39 cm in the group receiving heparin + dextran, while it was 1.76 ± 0.56 cm in the group receiving only heparin. ( p = 0.000). While there were only 1.24 ± 1.02 people in the group that received dextran at 72 h, leg pain persisted in 3.35 ± 1.11 people in the other group. ( p = 0.000). Evaluation was made only with calf vein diameter measurement. When patients with Homan’s sign were evaluated for their calf pain at foot dorsiflexion; both groups had decreased pain at 48th and 72nd hours. Conclusion In this study, we observed that the use of dextran 40 infusion therapy concomitantly with unfractionated heparin accelerates recovery substantially and decreases patient complaints significantly in early stages. In particular, reduction in leg pain and calf circumference reduction were more adequate in the dextran group. The early decrease in the calf circumference will have clinical consequences such as less heparin intake, earlier return to normal life, and a decrease in the total cost of treatment. Since the antithrombotic and anticoagulant effects of dextran are well known, we think that its use in this treatment as well as venous thromboembolism prophylaxis should be discussed.

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Plasmin-α2-antiplasmin complexes (plasmin—plasmin inhibitor complexes)

Cited by 2 publications

References 37 publications

The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo

The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo

The usage and outcomes of dextran in the treatment of acute deep venous thrombosis

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