[Fibrinolysis and vascular diseases]

A wide array of in vitro fibrinolysis tests had been performed for a long period, suggesting defective fibrinolysis, mainly impaired tPA response and reserve as major, frequent abnormality, predecessor or causative factor of venous thromboembolism. However, these abnormalities were troublesome to reproduce, and more recently fibrinolytic activators and inhibitors received growing attention as rather atherogenic and less thrombogenic risk factors. Even if it is still not settled, lipoprotein(a) may interfere with fibrinolysis, and seems to carry atherogenic risk, too. The genetic polymorphism of fibrinogen, plasminogen, PAI-1 and some other compounds modifying circulating fibrinogen levels are also discussed in this review.