ABSTRACT
In this review we discuss the association of overall hypofibrinolysis and individual
fibrinolytic protein levels with venous and arterial thrombosis. Decreased overall
fibrinolytic potential and high plasma levels of thrombin-activatable fibrinolysis
inhibitor have been consistently associated with risk of venous thrombosis, whereas
little evidence exists for a role of plasminogen, α2-antiplasmin, tissue plasminogen
activator, and plasminogen activator inhibitor 1. Overall fibrinolytic potential has
been associated with arterial thrombosis in young individuals, but studies on the
individual components gave conflicting results. These inconsistent results could be
a consequence of nonfibrinolytic properties of fibrinolytic proteins, including roles
in inflammation, vascular remodeling, atherosclerosis, and the metabolic syndrome.
The nonfibrinolytic properties of these proteins may have opposing effects on development
of arterial disease as compared with the lytic properties, which may explain opposite
results in different studies with slightly different population characteristics. These
properties may be more relevant in arterial than in venous thrombosis.
KEYWORDS
Fibrinolysis - arterial thrombosis - venous thrombosis
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Ton LismanPh.D.
Surgical Research Laboratory, Department of Surgery, University Medical Center Groningen
University of Groningen, the Netherlands
eMail: J.A.Lisman@chir.umcg.nl
