[Which laboratory parameters are useful and necessary in fibrinolytic therapy?]

Even sophisticated assays of blood coagulation and of fibrinolysis cannot predict the clinical success of thrombolytic therapy, nor can they prevent bleeding complications. Nevertheless, some laboratory monitoring is indicated before thrombolytic therapy to rule out contraindications, and it should also be performed during thrombolytic therapy as a guideline for substitution therapy in case of bleeding and for control of concommitant or subsequent anticoagulant therapy. An initial assessment should comprise the assay of fibrinogen, prothrombin time, partial thromboplastin time, and a platelet count. One to two hours after initiation of thrombolytic therapy and at its end (as well as at 12-hourly intervals in between in prolonged courses of thrombolytic therapy), a fibrinogen assay and a test that is sensitive to fibrin(ogen) degradation products (e.g. thrombin time, reptilase time, prothrombin time) should be performed.