Cardiology & Vascular Research

Cardiology & Vascular Research

Open Access
ISSN: 2639-8486
Review Article

Using tPA Alone for Fibrinolysis has been A Longstanding Mistake

Authors: Victor Gurewich.

DOI: 10.33425/2639-8486.1102


Abstract

Fibrinolysis has used tissue plasminogen activator (tPA) alone ever since it replaced Streptokinase (SK) in therapeutic fibrinolysis. This was based on the belief that tPA was responsible for natural fibrinolysis. When prourokinase plasminogen activator was discovered (prouPA) in 1980, it was believed to be an extravascular plasminogen activator. This has turned out to be a mistaken concept. Out of the three fibrin-bound plasminogens responsible for fibrinolysis, only the first one, the one which initiates fibrinolysis, is activated by tPA. The other two are activated by prouPA and two chain uPA (urokinase) respectively. Therefore, the functions of tPA and prouPA are analogous to those of the starter and the fuel in a car. By mimicking this natural model for therapy, fibrinolysis can be made much safer because high dose infusions of tPA, that can cause bleeding at vascular repair sites, are eliminated.

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Citation: Victor Gurewich. Using tPA Alone for Fibrinolysis has been A Longstanding Mistake. 2021; 5(2). DOI: 10.33425/2639-8486.1102
Editor-in-Chief
Aris Lacis
Aris Lacis
Head of the Latvian State Cardiology Centre for Children | Head of the Clinic for Children Cardiology Latvia

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