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The optimal method for measuring in vivo fibrinolysis has yet to be defined. In the present study we have compared methods that measure two different fragments produced when circulating plasmin digests fibrin(ogen). Double antibody radioimmunoassays were set up to measure fibrinogen fragments E (FgE) and Bβ1-42 and these detected less than 0.04 to 0.02 pmol/ml, respectively. Blood was collected into an anticoagulant containing EDTA, heparin, aprotinin and e aminocaproic acid and fibrinogen was removed with Reptilase or by ethanol precipitation. Normal plasma concentrations (n = 20) of FgE and Bβ1-42 were found to be 3.10 and 1.59 pmol/ml, respectively. Patients with heart valve replacements (n = 6) had mean FgE and Bβ1-42 plasma concentrations of 5.07 and 3.06 pmol/ml, respectively. Patients recovering from acute thrombotic stroke (n = 24) had elevated mean FgE and Bβ1-42 levels, 6.52 and 3.80 pmol/ml respectively, but the correlation between the individual results was poor. Sequential blood samples were taken from patients (n = 15) undergoing hip replacement operations. Pre operative mean plasma concentrations were 5.82 and 3.40 pmol/ml, respectively. Peak mean FgE plasma concentrations occurred on post operative day 1, 9.03 pmol/ml, while the Bβ1-42 maximum was on post operative day 4, 8.0 pmol/ml. Patients (n = 6) with renal failure had mean FgE and Bβ1-42 plasma concentrations of 5.39 and 36.9 pmol/ml, respectively. Haemodialysis increased these levels to 8.18 and 60.0 pmol/ ml, respectively, but not all of the patients exhibited an increase. It is concluded that (a) assays for FgE and Bβ31- 42 measure different aspects or stages of the vivo fibrinolytic process (b) following renal failure there is either a large production of early plasmin degradation fragments, or more likely, Bβ1-42 is inadequately catabolised by the kidney.

Measurement Of In Vivo Fibrinolysis: A Comparison Of Assays For Fibrinogen Fragments E And Bβl-42