Key result
Fibrinolytic management remains hindered by diagnostic gaps and a lack of therapies for hypofibrinolysis.
Why the study?
Accurate laboratory diagnosis of disturbed fibrinolysis remains challenging, and approved treatments for hypofibrinolysis in conditions like sepsis-related coagulopathy, CAD, and VTE are lacking.
This comprehensive review underscores the critical role of fibrinolysis in vascular and systemic diseases, emphasizing that the development of timely clinical diagnostic assays could enable personalized profibrinolytic or antifibrinolytic therapies.
The fibrinolytic system is a key player in keeping the haemostatic balance, and changes in fibrinolytic capacity can lead to both bleeding-related and thrombosis-related disorders. Our knowledge of the fibrinolytic system has expanded immensely during the last 75 years. From the first successful use of thrombolysis in myocardial infarction in the 1960s, thrombolytic therapy is now widely implemented and has reformed treatment in vascular medicine, especially ischemic stroke, while antifibrinolytic agents are used routinely in the prevention and treatment of major bleeding worldwide. Despite this, this research field still holds unanswered questions. Accurate and timely laboratory diagnosis of disturbed fibrinolysis in the clinical setting remains a challenge. Furthermore, despite growing evidence that hypofibrinolysis plays a central role in, e.g., sepsis-related coagulopathy, coronary artery disease, and venous thromboembolism, there is currently no approved treatment of hypofibrinolysis in these settings. The present review provides an overview of the fibrinolytic system and history of its discovery; measurement methods; clinical relevance of the fibrinolytic system in diagnosis and treatment; and points to future directions for research.
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Hvas et al. (2023) conducted a review in Disorders related to disturbed fibrinolysis (e.g., trauma, CAD, sepsis, VTE). Fibrinolytic system and diagnostic assays was evaluated. The fibrinolytic system plays a central role in hemostatic balance and numerous clinical disorders, yet optimal management is hindered by the lack of rapid, reliable clinical diagnostic assays and approved treatments for hypofibrinolysis.
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