Relationship between elevated fibrinopeptide A levels and alpha-2-antiplasmin

In order to investigate whether alpha 2-antiplasmin (alpha 2-AP) levels may be related to thrombin activity, we measured alpha 2-AP and fibrinopeptide A (FPA) in 51 patients with clinical conditions frequently associated with increased thrombin activity. The diagnoses were: atherosclerotic disease, chronic inflammatory disease and hematological neoplastic disease. A significant negative correlation was found between alpha 2-AP and FPA (p less than 0.01). When patients were divided into three subgroups on the basis of their FPA levels, a significant reduction in alpha 2-AP was found in patients with the highest FPA concentration (greater than 9 ng/ml). Accordingly, a significant negative relationship between alpha 2-AP and FPA was found only in this subgroup (p less than 0.01). Our data suggest that the partial consumption of alpha 2-AP in patients with elevated FPA levels may reflect a subclinical fibrinolysis activation secondary to increased thrombin activity.

alpha 2 Antiplasmin and disseminated intravascular coagulation in liver cirrhosis

Subnormal concentrations of alpha 2 Antiplasmin (alpha 2 AP) in liver cirrhosis may be due to an impaired hepatic synthesis and/or to a fibrinolysis activation in disseminated intravascular coagulation (DIC). In order to clarify this problem, in 26 cirrhotic patients (15 compensated and 11 decompensated) alpha 2 AP plasma activity and plasma Fibrinopeptide A (FPA) were measured. Serum albumin, p-Cholinesterase (p-CHE), Fibrinogen and Fibrinogen Degradation Products (FDP) were also carried out. Our data show that alpha 2 AP and FPA were equally abnormal in compensated and decompensated cirrhosis. The significant negative correlation obtained between alpha 2 AP and FPA as well as the lack of correlation between alpha 2 AP and albumin, alpha 2 AP and p-CHE in both groups suggests that, in our patients, alpha 2 AP decrease may be due to a fibrinolysis activation induced by a DIC which appears chronic since Fibrinogen and FDP were normal. These findings are in agreement with the results obtained in the four subgroups a posteriori selected on the basis of FPA levels: alpha 2 AP in subgroups with high FPA was significantly different from controls while it did not differ in subgroups with normal FPA.