Acquired defects of fibrinolysis associated with thrombosis

Physiologic regulation of fibrinolysis plays an important role in the contr ol of hypercoagulable states and thrombogenesis. Both the hereditary and ac quired conditions leading to fibrinolytic deficit result in thrombotic comp lications leading to arterial and venous occlusive disorders. Several chang es in physiologic states such as pregnancy, old age, stress, obesity, and t emperature alterations lead to the modulation of the fibrinolytic system. V arious disease states, surgery, radiation, and diet can also trigger mechan isms leading to impaired fibrinolytic states. Several drugs, including anti cancer agents, oral contraceptives, cytokines, and blood components can als o produce transitory fibrinolytic deficit which can predispose patients to thrombotic complications. The identification of the patient populations wit h an impaired fibrinolytic state is an important step toward the prevention of thrombotic complications which may lead to such catastrophic events as myocardial infarction and thrombotic strokes. Both functional and immunolog ic methods have currently become available for the rapid diagnosis of fibri nolytic deficit. Thus, it is important to evaluate patients who are at risk of thrombotic complications due to fibrinolytic deficit. Currently, specif ic guidelines are developed to identify high risk groups and propose method s to manage these groups of patients.