84:
321:
are used as inhibitors of fibrinolysis. Their application may be beneficial in patients with hyperfibrinolysis because they arrest bleeding rapidly if the other components of the haemostatic system are not severely affected. This may help to avoid the use of blood products such as fresh frozen plasma
264:
However, acquired disturbance of fibrinolysis (hyperfibrinolysis), is not uncommon. Many trauma patients have an overwhelming activation of tissue factor and thus massive hyperfibrinolysis. Hyperfibrinolysis may occur in other disease states. It could lead to massive bleeding if not diagnosed and
112:
of the blood vessels, such that, after several days (when the bleeding has stopped), the clot is broken down. This occurs because plasminogen became entrapped within the clot when it formed; as it is slowly activated, it breaks down the fibrin mesh. t-PA and urokinase are themselves inhibited by
159:(FDPs). FDPs compete with thrombin, and thus slow down clot formation by preventing the conversion of fibrinogen to fibrin. This effect can be seen in the thrombin clotting time (TCT) test, which is prolonged in a person that has active fibrinolysis.
225:) from plasma and then observing the time required for clot dissolution. A shortened lysis time indicates a hyperfibrinolytic state and bleeding risk. Such results can be seen in peoples with liver disease,
194:. Clinically, the TEM is useful for near real-time measurement of activated fibrinolysis for at-risk patients, such as those experiencing significant blood loss during surgery.
307:
Thrombolysis refers to the dissolution of the thrombus due to various agents while fibrinolysis refers specifically to the agents causing fibrin breakdown in the clot.
2165:
166:, can be measured using antibody-antigen technology. This is more specific than the TCT, and confirms that fibrinolysis has occurred. It is therefore used to indicate
749:
631:"Utilization of catheter-directed thrombolysis in pulmonary embolism and outcome difference between systemic thrombolysis and catheter-directed thrombolysis"
1141:
108:
are the agents that convert plasminogen to the active plasmin, thus allowing fibrinolysis to occur. t-PA is released into the blood slowly by the damaged
1995:
1233:
1325:
98:, in the liver. Although plasminogen cannot cleave fibrin, it still has an affinity for it, and is incorporated into the clot when it is formed.
175:
2109:
1010:
190:. In this assay, increased fibrinolysis is assessed by comparing the TEM profile in the absence or presence of the fibrinolysis inhibitor
742:
1136:
1480:
1058:
1053:
570:
496:
118:
114:
1187:
1276:
272:, and plays a role in disease states associated with inflammation. Plasmin, in addition to lysing fibrin clots, also cleaves the
2151:
2090:
1498:
1471:
1211:
1015:
851:
1425:
791:
2158:
1226:
1091:
735:
41:
from growing and becoming problematic. Primary fibrinolysis is a normal body process, while secondary fibrinolysis is the
121:(PAI-1 and PAI-2). In contrast, plasminogen further stimulates plasmin generation by producing more active forms of both
2224:
1709:
1043:
594:
Tieu BH, Holcomb JB, Schreiber MA (May 2007). "Coagulopathy: its pathophysiology and treatment in the injured patient".
210:
122:
101:
2126:
1800:
1520:
63:
cuts the fibrin mesh at various places, leading to the production of circulating fragments that are cleared by other
201:(ELT) assay. The ELT measures fibrinolysis by clotting the euglobulin fraction (primarily the fibrinolytic factors
156:
1882:
1856:
1848:
1131:
182:. Alternatively, a more rapid detection of fibrinolytic activity, especially hyperfibrinolysis, is possible with
1219:
297:
2114:
1463:
1387:
957:
953:
2203:
1991:
1072:
816:
785:
289:
198:
179:
136:
34:
2053:
1632:
1587:
1113:
522:"Evaluation of rotation thrombelastography for the diagnosis of hyperfibrinolysis in trauma patients"
167:
1443:
1123:
1100:
1081:
1063:
758:
253:
disorders of the fibrinolytic system have been documented. Nevertheless, excess levels of PAI and α
230:
214:
144:
128:
1734:
766:
301:
258:
183:
171:
396:
276:
component C3, and fibrin degradation products have some vascular permeability inducing effects.
1896:
1299:
1294:
1978:
1749:
1739:
1729:
1724:
1719:
1694:
1267:
1254:
1246:
1151:
1108:
721:
701:
652:
611:
576:
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543:
502:
492:
469:
314:
273:
629:
Patel N, Patel NJ, Agnihotri K, Panaich SS, Thakkar B, Patel A, et al. (December 2015).
1952:
1783:
1744:
1714:
1164:
1159:
691:
683:
642:
603:
533:
459:
310:
2198:
1756:
831:
810:
796:
318:
293:
147:(TAFI), which modifies fibrin to make it more resistant to the tPA-mediated plasminogen.
2120:
1647:
1333:
1242:
1169:
696:
671:
288:(the breakdown of a thrombus), fibrinolytic drugs are used. They are given following a
2218:
2077:
2047:
1637:
1622:
1617:
1578:
1250:
982:
906:
861:
464:
447:
341:
87:
Fibrinolysis (simplified). Blue arrows denote stimulation, and red arrows inhibition.
2067:
2037:
2015:
2010:
1983:
1932:
1911:
1761:
1700:
1656:
1533:
1476:
1415:
1410:
1391:
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1258:
990:
356:
351:
336:
331:
285:
269:
42:
520:
Levrat A, Gros A, Rugeri L, Inaba K, Floccard B, Negrier C, David JS (June 2008).
421:
687:
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2174:
1937:
1865:
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1667:
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1651:
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1348:
1338:
1033:
968:
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896:
886:
841:
775:
346:
300:
to allow blood flow back to the affected part of the brain; and in the event of
222:
109:
95:
53:
2177:
2042:
1959:
1942:
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1375:
1359:
1355:
1304:
949:
911:
871:
866:
856:
607:
250:
202:
2030:
2025:
2005:
2000:
1947:
1901:
1875:
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1819:
1677:
1600:
1564:
1538:
1503:
1491:
1453:
1448:
1438:
1400:
1370:
1365:
1343:
1309:
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1005:
1000:
995:
881:
876:
580:
506:
371:
191:
105:
17:
705:
656:
615:
547:
473:
83:
2143:
1824:
1809:
1642:
1613:
1604:
1592:
1559:
1405:
944:
934:
929:
538:
521:
376:
64:
38:
2095:
2085:
2062:
1860:
1689:
1433:
1196:
1038:
187:
163:
91:
60:
727:
647:
630:
2057:
963:
820:
361:
68:
57:
49:
322:
with its associated risks of infections or anaphylactic reactions.
1319:
805:
800:
366:
238:
237:
deficiency. Similar results are also seen after administration of
226:
206:
82:
72:
670:
Levy JH, Koster A, Quinones QJ, Milling TJ, Key NS (March 2018).
1964:
825:
2147:
1215:
731:
563:
Disorders of hemostasis and thrombosis : a clinical guide
1011:
Protein Z-related protease inhibitor (ZPI) (inhibits FX, FXI)
45:
due to a medicine, a medical disorder, or some other cause.
672:"Antifibrinolytic Therapy and Perioperative Considerations"
268:
The fibrinolytic system is closely linked to control of
143:
inactivate plasmin. Plasmin activity is also reduced by
1016:
Tissue factor pathway inhibitor (TFPI) (inhibits FIII)
197:
Testing of overall fibrinolysis can be measured by a
155:
Plasmin breaks down fibrin into soluble parts called
2076:
1977:
1920:
1847:
1799:
1688:
1676:
1586:
1577:
1547:
1519:
1462:
1424:
1386:
1318:
1275:
1266:
1178:
1150:
1122:
1099:
1090:
1024:
981:
920:
895:
840:
774:
765:
1082:Thrombin-activatable fibrinolysis inhibitor (TAFI)
487:Cotran RS, Kumar V, Collins T, Robbins SL (1999).
1142:Activated protein C–protein C inhibitor (APC–PCI)
724:of the fibrinolytic pathway (site not available)
565:. New York: McGraw-Hill, Medical Pub. Division.
991:Antithrombin (inhibits FII, FIX, FX, FXI, FXII)
27:Process that prevents blood clots from growing
2159:
1227:
743:
8:
145:thrombin-activatable fibrinolysis inhibitor
2166:
2152:
2144:
1685:
1583:
1272:
1234:
1220:
1212:
1096:
771:
750:
736:
728:
186:(TEM) in whole blood, even in patients on
1059:Plasminogen activator inhibitor-2 (PAI-2)
1054:Plasminogen activator inhibitor-1 (PAI-1)
695:
646:
537:
463:
446:Cesarman-Maus G, Hajjar KA (May 2005).
387:
852:High-molecular-weight kininogen (HMWK)
448:"Molecular mechanisms of fibrinolysis"
292:to dissolve the thrombus blocking the
422:"Fibrinolysis - primary or secondary"
257:-antiplasmin have been implicated in
7:
1137:Thrombin–antithrombin complex (TAT)
489:Robbins pathologic basis of disease
395:BSc, Samuel Mckenzie (2019-03-27).
178:and efficacy of treatment in acute
1044:Tissue plasminogen activator (tPA)
1001:Protein S (cofactor for protein C)
561:Goodnight SH, Hathaway WE (2001).
261:and various other disease states.
25:
119:plasminogen activator inhibitor-2
115:plasminogen activator inhibitor-1
94:is produced in an inactive form,
1849:Direct thrombin (IIa) inhibitors
1277:Glycoprotein IIb/IIIa inhibitors
465:10.1111/j.1365-2141.2005.05444.x
1472:Thromboxane synthase inhibitors
1132:Prothrombin fragment 1+2 (F1+2)
792:Platelet membrane glycoproteins
996:Protein C (inhibits FV, FVIII)
452:British Journal of Haematology
162:FDPs, and a specific FDP, the
1:
1710:Low-molecular-weight heparin
1521:Phosphodiesterase inhibitors
1434:Acetylsalicylic acid/Aspirin
688:10.1097/ALN.0000000000001997
123:tissue plasminogen activator
102:Tissue plasminogen activator
872:Factor XII (Hageman factor)
786:von Willebrand factor (vWF)
157:fibrin degradation products
56:, is broken down. Its main
2241:
1192:-antiplasmin complex (PAP)
907:Factor III (tissue factor)
635:Catheter Cardiovasc Interv
491:. Philadelphia: Saunders.
317:(ε-aminocaproic acid) and
2184:
2104:
1682:(with some II inhibition)
608:10.1007/s00268-006-0653-9
296:; experimentally after a
1114:β-Thromboglobulin (β-TG)
722:Graphical representation
241:or after severe stress.
1109:Platelet factor 4 (PF4)
1006:Protein Z (inhibits FX)
940:Prothrombin (factor II)
397:"What is Fibrinolysis?"
1992:Plasminogen activators
1464:Thromboxane inhibitors
1388:Prostaglandin analogue
1165:Fibrinopeptide B (FpB)
1160:Fibrinopeptide A (FpA)
832:Glycoprotein VI (GPVI)
797:Glycoprotein Ib (GPIb)
265:treated early enough.
88:
2204:Platelet adhesiveness
2054:serine endopeptidases
1588:Vitamin K antagonists
983:Anticoagulant factors
950:Fibrinogen (factor I)
945:Thrombin (factor IIa)
817:Glycoprotein IIb/IIIa
811:Glycoprotein IX (GP9)
778:(platelet activation)
199:euglobulin lysis time
180:myocardial infarction
125:(tPA) and urokinase.
86:
52:clot, the product of
1801:Direct Xa inhibitors
1633:Ethyl biscoumacetate
1499:Receptor antagonists
1170:Fibrin monomers (FM)
1026:Fibrinolytic factors
844:(contact activation)
326:Fibrinolytic enzymes
284:In a process called
168:deep-vein thrombosis
2225:Fibrinolytic system
1444:Carbasalate calcium
1124:Thrombin generation
1101:Platelet activation
1092:Coagulation markers
767:Coagulation factors
759:Coagulation cascade
48:In fibrinolysis, a
2131:Never to phase III
1979:Thrombolytic drugs
1695:glycosaminoglycans
1268:Antiplatelet drugs
1255:antiplatelet drugs
964:Fibrin (factor Ia)
776:Primary hemostasis
539:10.1093/bja/aen083
302:pulmonary embolism
259:metabolic syndrome
184:thromboelastometry
172:pulmonary embolism
89:
43:breakdown of clots
2212:
2211:
2141:
2140:
1973:
1972:
1843:
1842:
1573:
1572:
1209:
1208:
1205:
1204:
1152:Fibrin generation
977:
976:
897:Extrinsic pathway
842:Intrinsic pathway
648:10.1002/ccd.26108
315:aminocaproic acid
311:Antifibrinolytics
274:complement system
16:(Redirected from
2232:
2168:
2161:
2154:
2145:
1953:Drotrecogin alfa
1933:Antithrombin III
1784:Dermatan sulfate
1757:Oligosaccharides
1686:
1584:
1320:ADP receptor/P2Y
1273:
1236:
1229:
1222:
1213:
1097:
772:
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2199:Clot retraction
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2121:Clinical trials
2100:
2072:
1982:
1969:
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1648:1,3-Indandiones
1590:
1569:
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1420:
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1334:Thienopyridines
1323:
1314:
1262:
1243:Antithrombotics
1240:
1210:
1201:
1191:
1174:
1146:
1118:
1086:
1076:
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973:
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899:(tissue factor)
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328:
319:tranexamic acid
294:coronary artery
282:
256:
247:
245:Role in disease
234:
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153:
140:
132:
81:
28:
23:
22:
15:
12:
11:
5:
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2148:
2139:
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2132:
2129:
2118:
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2106:
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2020:
2019:
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2008:
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1610:
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1581:
1579:Anticoagulants
1575:
1574:
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1441:
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1426:COX inhibitors
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1403:
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1251:anticoagulants
1241:
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1216:
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1120:
1119:
1117:
1116:
1111:
1105:
1103:
1094:
1088:
1087:
1085:
1084:
1079:
1077:-Macroglobulin
1074:
1070:
1065:
1061:
1056:
1051:
1046:
1041:
1036:
1030:
1028:
1022:
1021:
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922:Common pathway
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716:External links
714:
712:
711:
682:(3): 657–670.
676:Anesthesiology
662:
641:(7): 1219–27.
621:
602:(5): 1055–64.
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571:
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229:deficiency or
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141:-macroglobulin
138:
130:
80:
77:
37:that prevents
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
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2078:Non-medicinal
2075:
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2066:
2064:
2061:
2059:
2055:
2051:
2049:
2048:Streptokinase
2046:
2044:
2041:
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2032:
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2017:
2014:
2012:
2009:
2007:
2004:
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1997:
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1984:fibrinolytics
1980:
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1765:
1763:
1760:
1759:
1758:
1755:
1751:
1748:
1746:
1743:
1741:
1738:
1736:
1733:
1731:
1728:
1726:
1723:
1721:
1718:
1716:
1713:
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1708:
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1705:
1702:
1696:
1691:
1687:
1684:
1679:
1675:
1669:
1665:
1663:
1660:
1658:
1655:
1653:
1649:
1646:
1644:
1641:
1639:
1638:Phenprocoumon
1636:
1634:
1631:
1629:
1626:
1624:
1623:Coumatetralyl
1621:
1619:
1618:Acenocoumarol
1615:
1612:
1611:
1609:
1606:
1602:
1598:
1594:
1589:
1585:
1582:
1580:
1576:
1566:
1563:
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1556:
1553:
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1546:
1540:
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1527:
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1500:
1497:
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1478:
1475:
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1470:
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1467:
1465:
1461:
1455:
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1447:
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1437:
1435:
1432:
1431:
1429:
1427:
1423:
1417:
1414:
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1409:
1407:
1404:
1402:
1399:
1398:
1396:
1393:
1389:
1385:
1377:
1374:
1372:
1369:
1367:
1364:
1363:
1361:
1357:
1354:
1350:
1347:
1345:
1342:
1340:
1337:
1336:
1335:
1332:
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1329:
1327:
1324:
1317:
1311:
1308:
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1303:
1301:
1298:
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1288:
1286:
1283:
1282:
1280:
1278:
1274:
1271:
1269:
1265:
1260:
1256:
1252:
1248:
1247:thrombolytics
1244:
1237:
1232:
1230:
1225:
1223:
1218:
1217:
1214:
1198:
1195:
1193:
1186:
1185:
1183:
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1177:
1171:
1168:
1166:
1163:
1161:
1158:
1157:
1155:
1153:
1149:
1143:
1140:
1138:
1135:
1133:
1130:
1129:
1127:
1125:
1121:
1115:
1112:
1110:
1107:
1106:
1104:
1102:
1098:
1095:
1093:
1089:
1083:
1080:
1078:
1071:
1069:
1062:
1060:
1057:
1055:
1052:
1050:
1047:
1045:
1042:
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1037:
1035:
1032:
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1027:
1023:
1017:
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1009:
1007:
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1002:
999:
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992:
989:
988:
986:
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965:
962:
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948:
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938:
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933:
931:
928:
927:
925:
923:
919:
913:
910:
908:
905:
904:
902:
900:
894:
888:
885:
883:
880:
878:
875:
873:
870:
868:
865:
863:
862:Prekallikrein
860:
858:
855:
853:
850:
849:
847:
845:
839:
833:
830:
827:
824:
822:
818:
815:
812:
809:
807:
804:
802:
798:
795:
793:
789:
787:
784:
783:
781:
779:
773:
770:
768:
764:
760:
753:
748:
746:
741:
739:
734:
733:
730:
723:
720:
719:
715:
707:
703:
698:
693:
689:
685:
681:
677:
673:
666:
663:
658:
654:
649:
644:
640:
636:
632:
625:
622:
617:
613:
609:
605:
601:
597:
590:
587:
582:
578:
574:
572:0-07-134834-4
568:
564:
557:
554:
549:
545:
540:
535:
531:
527:
523:
516:
513:
508:
504:
500:
498:0-7216-7335-X
494:
490:
483:
480:
475:
471:
466:
461:
458:(3): 307–21.
457:
453:
449:
442:
439:
427:
423:
416:
413:
402:
398:
391:
388:
382:
378:
375:
373:
370:
368:
365:
363:
360:
358:
355:
353:
350:
348:
345:
343:
342:Streptokinase
340:
338:
335:
333:
330:
329:
325:
323:
320:
316:
312:
308:
305:
303:
299:
295:
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279:
277:
275:
271:
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262:
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244:
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236:
228:
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212:
208:
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195:
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189:
185:
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177:
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158:
150:
148:
146:
142:
134:
126:
124:
120:
116:
111:
107:
103:
99:
97:
93:
85:
78:
76:
74:
70:
66:
62:
59:
55:
51:
46:
44:
40:
36:
32:
19:
2194:Fibrinolysis
2193:
2068:Fibrinolysin
2038:Anistreplase
2016:Desmoteplase
2011:Tenecteplase
1912:Ximelagatran
1762:Fondaparinux
1701:antithrombin
1657:Diphenadione
1534:Dipyridamole
1477:Dipyridamole
1416:Treprostinil
1411:Prostacyclin
1290:Eptifibatide
1197:D-Dimer (DD)
1180:Fibrinolysis
1179:
1068:-Antiplasmin
1025:
790:
679:
675:
665:
638:
634:
624:
599:
596:World J Surg
595:
589:
562:
556:
532:(6): 792–7.
529:
526:Br J Anaesth
525:
515:
488:
482:
455:
451:
441:
429:. Retrieved
425:
415:
404:. Retrieved
401:News-Medical
400:
390:
357:Serrapeptase
352:Lumbrokinase
337:Desmoteplase
332:Anistreplase
309:
306:
290:heart attack
286:thrombolysis
283:
280:Pharmacology
270:inflammation
267:
263:
248:
235:-antiplasmin
219:-antiplasmin
196:
161:
154:
133:-Antiplasmin
127:
100:
90:
47:
31:Fibrinolysis
30:
29:
18:Fibrinolytic
2189:Coagulation
2175:Coagulation
2117:from market
1938:Defibrotide
1866:Bivalirudin
1835:Rivaroxaban
1774:Heparinoids
1767:Idraparinux
1668:Tioclomarol
1662:Phenindione
1652:Clorindione
1555:Cloricromen
1349:Ticlopidine
1339:Clopidogrel
1034:Plasminogen
969:Factor XIII
887:Factor VIII
426:MedlinePlus
420:Dugdale D.
347:Nattokinase
223:plasminogen
151:Measurement
110:endothelium
104:(t-PA) and
96:plasminogen
54:coagulation
39:blood clots
2178:physiology
2043:Monteplase
1960:Ramatroban
1943:Nafamostat
1928:Abelacimab
1907:Melagatran
1892:Dabigatran
1887:Argatroban
1830:Otamixaban
1815:Betrixaban
1803:("xabans")
1789:Sulodexide
1779:Danaparoid
1750:Tinzaparin
1740:Parnaparin
1735:Nadroparin
1730:Enoxaparin
1725:Dalteparin
1720:Certoparin
1680:inhibitors
1628:Dicoumarol
1529:Cilostazol
1509:Terutroban
1487:Picotamide
1376:Ticagrelor
1360:nucleoside
1356:Nucleotide
1326:inhibitors
1305:Sibrafiban
912:Factor VII
867:Kallikrein
857:Bradykinin
406:2024-05-31
383:References
313:, such as
251:congenital
203:fibrinogen
79:Physiology
67:or by the
2127:Phase III
2115:Withdrawn
2031:Urokinase
2026:Saruplase
2006:Reteplase
2001:Alteplase
1948:Protein C
1902:Inogatran
1897:Efegatran
1883:Univalent
1876:Lepirudin
1871:Desirudin
1820:Darexaban
1745:Reviparin
1715:Bemiparin
1678:Factor Xa
1614:Coumarins
1591:(inhibit
1565:Vorapaxar
1539:Triflusal
1504:Terbogrel
1492:Terbogrel
1481:+ aspirin
1454:Triflusal
1449:Indobufen
1439:Aloxiprin
1401:Beraprost
1371:Elinogrel
1366:Cangrelor
1344:Prasugrel
1310:Tirofiban
1300:Roxifiban
1295:Orbofiban
1285:Abciximab
1188:Plasmin-α
1049:Urokinase
882:Factor IX
877:Factor XI
431:August 7,
372:Bromelain
192:aprotinin
106:urokinase
65:proteases
2219:Category
1857:Bivalent
1825:Edoxaban
1810:Apixaban
1643:Warfarin
1560:Ditazole
1406:Iloprost
1362:analogs
935:Factor V
930:Factor X
706:29200009
657:26308961
616:17426904
581:45485184
548:18440953
507:39465455
474:15842654
377:Honokiol
2096:Oxalate
2086:Citrate
2063:Brinase
1861:Hirudin
1690:Heparin
1666:Other:
1039:Plasmin
697:5811331
188:heparin
164:D-dimer
92:Plasmin
61:plasmin
35:process
2110:WHO-EM
2058:Ancrod
2052:Other
1699:(bind
1692:group/
826:GPIIIa
704:
694:
655:
614:
579:
569:
546:
505:
495:
472:
362:Papain
298:stroke
221:, and
69:kidney
58:enzyme
50:fibrin
1996:r-tPA
1921:Other
1548:Other
821:GPIIb
806:GP1BB
801:GP1BA
367:DNase
239:DDAVP
227:PAI-1
207:PAI-1
73:liver
33:is a
2091:EDTA
2022:UPA
1965:REG1
1392:PGI2
1253:and
702:PMID
653:PMID
612:PMID
577:OCLC
567:ISBN
544:PMID
503:OCLC
493:ISBN
470:PMID
433:2011
249:Few
135:and
117:and
71:and
1597:VII
1259:B01
1257:) (
958:FGG
954:FGA
692:PMC
684:doi
680:128
643:doi
604:doi
534:doi
530:100
460:doi
456:129
211:tPA
176:DIC
2221::
2123::
2056::
1994::
1885::
1859::
1650::
1616::
1603:,
1601:IX
1599:,
1595:,
1593:II
1322:12
1249:,
956:,
700:.
690:.
678:.
674:.
651:.
639:86
637:.
633:.
610:.
600:31
598:.
575:.
542:.
528:.
524:.
501:.
468:.
454:.
450:.
424:.
399:.
304:.
213:,
209:,
205:,
174:,
170:,
75:.
2167:e
2160:t
2153:v
1981:/
1703:)
1697:/
1607:)
1605:X
1483:)
1479:(
1394:)
1390:(
1358:/
1261:)
1245:(
1235:e
1228:t
1221:v
1190:2
1075:2
1073:α
1066:2
1064:α
960:)
952:(
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819:(
813:)
799:(
794::
751:e
744:t
737:v
708:.
686::
659:.
645::
618:.
606::
583:.
550:.
536::
509:.
476:.
462::
435:.
409:.
255:2
233:2
231:α
217:2
215:α
139:2
137:α
131:2
129:α
20:)
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