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Paper| Volume 40, ISSUE 6, P769-777, December 15, 1985

The thrombolytic and hemorrhagic effects of tissue type plasminogen activator: Influence of dosage regimens in rabrits

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      Abstract

      Tissue type plasminogen activator (t-PA) is an effective thrombolytic agent in experimental animals and in humans. We have previously observed that the thrombolytic effect of t-PA persists beyond its time of clearance from the circulation and that wound bleeding induced by a high dose infusion of t-PA is delayed for at least one and a half hours after commencing the infusion. These observations suggest that improved thrombolysis may be obtained with t-PA by infusing a high dose over a short period of time. To test this hypothesis we compared the thrombolytic and hemorrhagic effects of t-PA infused over 240, 60, 30 and 15 minutes in the rabbit.
      A 4 hour infusion of 30, 000 U/kg of t-PA produced 36% thrombolysis. The same dose of t-PA infused over 60, 30 and 15 minutes produced 87%, 88% and 96% thrombolysis, respectively (p<0.01). The 1 hour infusion of 30, 000 U/kg of t-PA produced a significant increase in blood loss relative to saline infusion (p<0.01). The same dose infused over 30 and 15 minutes did not produce significantly more bleeding than saline. A higher dose of t-PA, 60, 000 U/kg, infused over 4 hours, produced 95% thrombolysis, but was associated with a significant increase of blood loss (p<0.001).
      Our findings suggest that improved thrombolysis with t-PA with minimal bleeding side-effects is achieved in rabbits when t-PA is administered in a relatively high dose given over a short period of time.

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      References

        • Matsuo O.
        • Rijken D.C.
        • Collen D.
        Thrombolysis by human tissue plasminogen activator and urokinase in rabbits with experimental pulmonary embolus.
        Nature. 1981; 291: 590-591
        • Korniger C.
        • Matsuo O.
        • Suy R.
        • Stassen U.M.
        • Collen D.
        Thrombolysis with human extrinsic (tissue-type) plasminogen activator in dogs with femoral vein thrombosis.
        J. Clin. Invest. 1982; 69: 573-580
        • Collen D.
        • Stassen J.M.
        • Verstraete M.
        Thrombolysis with human extrinsic (tissue-type) plasminogen activator in rabbits with experimental jugular vein thrombosis.
        J. Clin. Invest. 1983; 71: 368-376
        • Bergmann S.R.
        • Fox K.A.A.
        • Ter-Pogossian M.M.
        • Sobel B.E.
        • Collen D.
        Clot-selective thrombolysis with tissue-type plasminogen activator.
        Science. 1983; 220: 1181-1183
        • Van de Werf F.
        • Bergmann S.R.
        • Fox K.A.A.
        • De Geest H.
        • Hoyng C.F.
        • Sobel B.E.
        • Collen D.
        Coronary thrombolysis with intravenously administered human tissue-type plasminogen activator produced by recombinant DNA technology.
        Circulation. 1984; 69: 605-610
        • Gold H.K.
        • Fallon J.T.
        • Yasuda T.
        • Leinbach R.C.
        • Khaw B.A.
        • Newell J.B.
        • Guerrero J.L.
        • Vislosky F.M.
        • Hoyng C.F.
        • Grossbard E.
        • Collen D.
        Coronary thrombolysis with recombinant human tissue plasminogen activator.
        Circulation. 1984; 70: 700-707
        • Weimar W.
        • Stibbe J.
        • Van Seyen A.J.
        • Billiau A.
        • De Somer P.
        • Collen D.
        Specific lysis of an iliofemoral thrombus by administration of extrinsic (tissue-type) plasminogen activator.
        Lancet. 1981; ii: 1018-1020
        • Van De Werf F.
        • Ludbrook P.A.
        • Bergmann S.R.
        • Tiefenbrunn A.J.
        • Fox K.A.A.
        • De Geest H.
        • Verstraete M.
        • Collen D.
        • Sobel B.
        Coronary thrombolysis with tissue-type plasminogen activator in patients with evolving myocardial infarction.
        N. Engl. J. Med. 1984; 310: 609-613
        • Sobel B.E.
        • Geltman E.M.
        • Tiefenbrunn A.J.
        • Jaffe A.S.
        • Spadaro J.J.
        • Ter-Pogossian M.M.
        • Collen D.
        • Ludbrook P.A.
        Improvement of regional myocardial metabolism after coronary thrombolysis induced with tissue-type plasminogen activator or streptokinase.
        Circulation. 1984; 69: 983-990
        • Grossbard E.
        • Gold H.
        • Tiefenbrunn A.
        • Topol E.
        • Brinker J.
        • Spadaro J.
        • Leinbach R.
        • Yasuda H.
        • Sobel B.
        • Weisfeldt M.
        • Collen D.
        Coronary thrombolysis with recombinant human tissue-type plasminogen activator.
        Circulation. 1984; 70 (abst.): 27
        • Agnelli G.
        • Buchanan M.R.
        • Fernandez F.
        • Van Ryn J.
        • Hirsh J.
        Sustained thrombolysis with DNA-recombinant tissue-type plasminogen activator in rabbits.
        Blood August. 1985; (in press)
        • Agnelli G.
        • Buchanan M.R.
        • Fernandez F.
        • Boneu B.
        • Van Ryn J.
        • Hirsh J.
        • Collen D.
        A comparison of the thrombolytic effect of tissue plasminogen activator and streptokinase in rabbits.
        Circulation. 1985; (in press)
        • Pennica D.
        • Holmes W.E.
        • Kohr W.J.
        • Harkins R.N.
        • Vehar G.A.
        • Ward C.A.
        • Bennett W.F.
        • Yelverton E.
        • Seeburg P.H.
        • Heyneker H.L.
        • Goeddel D.V.
        • Collen D.
        Cloning and expression of human tissue-type plasminogen activator cDNA in E. coll.
        Nature. 1983; 301: 214-221
        • Regoeczi E.
        Fibrinogen catabolism: Kinetics of catabolism following sudden elevation of the pool with exogenous fibrinogen.
        Clin. Sci. 1970; 38: 111-121
        • Teger-Nielsson A.C.
        • Friberger P.
        • Gyzander E.
        Determination of a new rapid plasmin inhibitor in human blood by means of a plasmin specific tripeptide substrate.
        Scand. J. Clin. Lab. Invest. 1977; 37: 403-409
        • Winder B.J.
        Statistical Principles in Experimental Design.
        in: McGraw Hill, New York1971: 191-196
        • Dunnett C.W.
        A multiple comparison procedure for comparing several treatments with a control.
        Am. Statist. Assoc. J. 1955; 50: 1096-1121
        • Collen D.
        On the regulation and control of fibrinolysis.
        Thromb. Haemostas. 1980; 43: 77-89
        • Kruithof E.K.O.
        • Tran-Thang C.
        • Ransijn A.
        • Bachmann F.
        Demonstration of a fast-acting inhibitor of plasminogen activators in human plasma.
        Blood. 1984; 64: 907-913