The Diurnal Increase in Euglobulin Fibrinolytic Activity in Women Using Oral Contraceptives and in Normal Women, and the Generation of Intrinsic Fibrinolytic Activity

Jespersen, Jørgen

doi:10.1055/s-0038-1661636

Cited by 21 publications

(4 citation statements)

References 6 publications

(12 reference statements)

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“…Furthermore, a diurnal-dependent depressed fibrinolytic activity (1 3-17) in the morning has been suggested to be related to the frequent onset of myocardial infarction at that time of day (6,7,9). Andreotti and colleagues ( 16) have studied in more detail diurnal variation of fibrinolysis in healthy volunteers and have shown that blood tissue type plasminogen activator (t-PA) activities and plasminogen activator inhibitor (PAI) activities fluctuate markedly over 24 h, with the lowest levels of t-PA activity and highest levels of PA1 activity occurring in the morning ( 13,14). This finding is confirmed in other reports (1 5-17), which show that the diurnal increase in systemic fibrinolytic activities is due to a decline in blood PA1 concentration and not significantly to an augmentation of t-PA.…”

Section: Discussionmentioning

confidence: 99%

Chronobiology of Coronary Risk Markers in Greenland Eskimos: A Comparative Study with Caucasians Residing in the Same Arctic Area

Johansen

Gram

Kluft³

et al. 1991

Chronobiology International

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We report a comparison of fibrinolytic variables between 10 Caucasians on a predominantly European diet and 10 Greenland Eskimos on a traditional Inuit diet containing a substantial amount of fish and sea animals. We studied the diurnal variation in tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) antigens and activities during a 24-h period. Blood samples were taken every 4 h. The variations of the sinusoidal curves were evaluated by the Friedman chi 2 test. t-PA and PAI-1 antigen in plasma fluctuated significantly during the 24 h (Eskimos p less than 0.00007 and p less than 0.0007; Caucasians p less than 0.00003 and p less than 0.02), with a peak in the early morning and a nadir in the afternoon. This also held true for PAI activity (Eskimos p less than 0.0008; Caucasians p less than 0.01), whereas t-PA activity showed an inverse but still significant pattern (Eskimos p less than 0.006; Caucasians p less than 0.0008). Amplitudes, areas underneath, and overall medians of the sinusoidal curves did not deviate between the two groups with respect to t-PA and PAI. In contrast to the significant variation of t-PA and PAI, the plasma concentrations of fibrin degradation products (D-Dimer), a measure of effective fibrinolysis, remained constant during the 24 h, and the absolute differences between groups did not reach statistical significance. These findings suggest that circadian variation of fibrinolytic activators and inhibitors is a basic biologic phenomenon, which is not affected by life-style, dietary habits, or ethnic differences.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 99%

Chronobiology of Coronary Risk Markers in Greenland Eskimos: A Comparative Study with Caucasians Residing in the Same Arctic Area

Johansen

Gram

Kluft³

et al. 1991

Chronobiology International

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“…These authors found a significant decrease in ECLT after a single injection of 60 mg heparin s.c. but not after placebo. Jespersen (23) has reported a diurnal variation in euglobulin fibrinolytic activity. The activity was low in the morning and high in the afternoon.…”

Section: Discussionmentioning

confidence: 99%

Heparin and Fibrinolysis - Comparison of Subcutaneous Administration of Unfractionated and Low Molecular Weight Heparin

et al. 1988

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SummaryThe effects on the fibrinolytic system after a single s.c. bolus injection (at 9 a.m.) of either 5000 IU conventional heparin or 5000 anti-Xa U of a fractionated low molecular weight heparin (Fragmin, KabiVitrum, Sweden) were investigated in 9 healthy volunteers. The effects were compared to those of an injection of normal saline in 6 volunteers. Samples for biochemical analyses were taken regularily during 6 hours after drug or placebo administration.In the coagulation system the following parameters were measured: Activated partial thromboplastin time (APTT), anti- Xa activity, thrombin time and fibrinogen. The fibrinolytic system was monitored by analysing: plasminogen, ɑ2-antiplasmin, fibrinogen) degradation products (FDP), euglobulin clot lysis time (ECLT), tissue plasminogen activator (t-PA) activity, t-PA antigen and plasminogen activator inhibitor (PAI) activity. Injection of the 2 drugs was followed by elevations in APTT and anti-Xa activity, and were more pronounced for Fragmin than heparin. The fibrinolytic system exhibited a diurnal variation with decreasing PAI activity and increasing t-PA activity during the day. Volunteers receiving normal saline (placebo) showed a similar pattern. The results were unrelated to heparin.It is concluded from this study that neither heparin nor Fragmin had any significant effect on the fibrinolytic parameters when measured after a single s.c. bolus injection since the observed variations were within the diurnal range.

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“…First, the blood samples were collected decentralized at different times of the day from apparently non-fasting, non-resting subjects, and centrifuged at decentralized facilities. Such uncontrolled preanalytical conditions might with respect to fibrinolytic variables result in variances which exceed by several times the analytical vari ance of the components analysed (22)(23)(24)(25)(26)(27)(28). Second, the cases included in the study were apparently not tested for coagulation inhibitor deficien cies or malignant diseases, both conditions carrying a genuine prone ness to venous thrombosis which is not necessarily dependent on the fibrinolytic state (29,30).…”

Section: Discussionmentioning

confidence: 99%

Does Low Protein Concentration of Tissue-type Plasminogen Activator Predict a Low Risk of Spontaneous Deep Vein Thrombosis?

1995

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SummaryMany reports have demonstrated an abnormal fibrinolysis in a subset of patients with deep vein thrombosis. We have studied systemic global fibrinolytic activity and protein concentrations of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) in plasma of 25 young patients with a previous instance of spontaneous deep vein thrombosis documented by phlebography and in 50 healthy controls. The two populations were comparable with respect to a number of base-line variables (age, height, weight, etc.), while the patients had significantly lower fibrinolytic activity (p <0.02), and significantly higher protein concentrations of t-PA (p <0.0001) and PAI-1 (p <0.0006).We used probit scale plots to identify the consequence of different cut-off points to separate patients from controls. Reasonable separation could be obtained for t-PA with a cut-off point of 5.2 ng/ml and for PAI-1 18 ng/ml. The sensitivity and specificity for these cut-off points were for t-PA 73% (95% confidence interval 63%-84%) and for PAI-1 67% (confidence interval 55%-77%). The negative predictive value with a cut-off point t-PA concentration of 5.2 ng/ml was 85% (95% confidence interval 70%-94%). We observed a significantly negative association between concentration of t-PA and fibrinolytic activity (rs = -0.47; p <0.005) and also between PAI-1 and fibrinolytic activity (rs = -0.78; p <0.005).We conclude that a young healthy population is characterized by low protein concentration of t-PA (and PAI-1) compared with young patients with a previous instance of spontaneous vein thrombosis, and we tentatively state that a low protein concentration of t-PA predicts a low risk of spontaneous deep vein thrombosis.

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The Diurnal Increase in Euglobulin Fibrinolytic Activity in Women Using Oral Contraceptives and in Normal Women, and the Generation of Intrinsic Fibrinolytic Activity

Cited by 21 publications

References 6 publications

Chronobiology of Coronary Risk Markers in Greenland Eskimos: A Comparative Study with Caucasians Residing in the Same Arctic Area

Chronobiology of Coronary Risk Markers in Greenland Eskimos: A Comparative Study with Caucasians Residing in the Same Arctic Area

Heparin and Fibrinolysis - Comparison of Subcutaneous Administration of Unfractionated and Low Molecular Weight Heparin

Does Low Protein Concentration of Tissue-type Plasminogen Activator Predict a Low Risk of Spontaneous Deep Vein Thrombosis?

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