PMID- 7482410
OWN - NLM
STAT- MEDLINE
DCOM- 19951206
LR  - 20081121
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 73
IP  - 5
DP  - 1995 May
TI  - Protection of single-chain urokinase-type plasminogen activator (scu-PA) in 
      aprotinin treated cardiac surgical patients undergoing cardiopulmonary bypass.
PG  - 825-8
AB  - Intraoperative high-dose aprotinin administration has been shown to reduce the 
      intra-and postoperative blood loss in cardiac surgery. The haemostatic effect has 
      been attributed to platelet preserving properties and to inhibition of contact 
      activation reducing thrombotic and fibrinolytic activity during and after 
      cardiopulmonary bypass (CPB). Here we report on the effects of aprotinin on 
      urokinase-type plasminogen activator, especially on the protection of the zymogen 
      single-chain urokinase-type plasminogen activator (scu-PA). scu-PA occurs cell 
      associated as well as free in the circulation (concentration 50 pM, half-life 5 
      min), and is potentially activated by kallikrein and plasmin, both potent targets 
      for aprotinin. The generated active two-chain u-PA (tcu-PA) is a powerful 
      activator of fibrinolysis. Sixteen male patients undergoing myocardial 
      revascularization were randomly assigned to aprotinin treatment (A) or control 
      group (C). Plasma concentration of total u-PA antigen and of the specific forms 
      scu-PA(zymogen) and tcu-PA(active enzyme) were measured at different stages 
      intraoperatively and two hours postoperatively. After an initial drop due to 
      haemodilution at the onset of CPB, the concentrations of circulating u-PA forms 
      restored intraoperatively in A, but remained subnormal in C until the end of the 
      observation period. The concentration of total u-PA antigen of shed mediastinal 
      blood was both in A and C two-fold higher than in the circulation, but the 
      antigen was preserved as the zymogen scu-PA in A and largely converted to an 
      inactive, non activatable form in C. Intra- and postoperative blood losses were 
      less than half the amount in A as compared to C.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Spannagl, M
AU  - Spannagl M
AD  - German Heart Center, Munich.
FAU - Dooijewaard, G
AU  - Dooijewaard G
FAU - Dietrich, W
AU  - Dietrich W
FAU - Kluft, C
AU  - Kluft C
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Blood Proteins)
RN  - 0 (Enzyme Precursors)
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 9087-70-1 (Aprotinin)
RN  - EC 3.4.21.73 (Urokinase-Type Plasminogen Activator)
SB  - IM
MH  - Aprotinin/pharmacology/*therapeutic use
MH  - Blood Loss, Surgical/*prevention & control
MH  - Blood Proteins/analysis
MH  - *Cardiopulmonary Bypass
MH  - Double-Blind Method
MH  - Enzyme Activation
MH  - Enzyme Precursors/metabolism
MH  - Fibrin Fibrinogen Degradation Products/analysis
MH  - Fibrinolysis/drug effects
MH  - Humans
MH  - Male
MH  - Premedication
MH  - Urokinase-Type Plasminogen Activator/*metabolism
EDAT- 1995/05/01 00:00
MHDA- 1995/05/01 00:01
CRDT- 1995/05/01 00:00
PHST- 1995/05/01 00:00 [pubmed]
PHST- 1995/05/01 00:01 [medline]
PHST- 1995/05/01 00:00 [entrez]
PST - ppublish
SO  - Thromb Haemost. 1995 May;73(5):825-8.