{
  "abstract": "The processes of clot formation and clot dissolution with fibrinolysis underpin the pathophysiological mechanisms of acute ischaemic stroke (AIS) and its treatment. Detailed understanding of the modulation of this system is required to develop effective and safe stroke therapeutics. Clot formation occurs with the interaction of the coagulation cascade, along with platelets and fibrin meshwork. Conversely, fibrinolysis involves the serine protease plasmin, its zymogen, plasminogen and its enzymatic conversion by tissue plasminogen activator. The regulators and inhibitors that modulate the interactions in clot formation and fibrinolysis can be potential targets for new and emerging stroke therapies. The aim of this narrative review is to help inform stroke clinicians and researchers about the role of the fibrinolytic system and its inhibitors in AIS and the potential for new therapeutic targets. We outline the processes involved in clot formation and dissolution, the role of endogenous inhibitors of the fibrinolytic system, followed by potential therapeutic targets including tissue plasminogen activators as well as novel therapies and adjuncts. Better understanding of these processes will provide insight into the variable response to current stroke fibrinolytics amongst AIS patients and help to develop new and improved AIS therapeutics in future.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, Alfred Hospital, Melbourne, 3004, Australia.",
    "Department of Clinical Neurosciences, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.",
    "Department of Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.",
    "Australian Centre for Blood Diseases, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia. robert.medcalf@monash.edu."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Oshi Swarup",
      "orcid": "0000-0003-4610-1803"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Anna H Balabanski",
      "orcid": "0000-0003-3209-3101"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Geoffrey C Cloud",
      "orcid": "0000-0002-8365-6907"
    },
    {
      "affs": [
        3
      ],
      "name": "Robert L Medcalf",
      "orcid": "0000-0001-6885-3892"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2h7vhgfndze4t.bib",
  "cited_by": 0,
  "doi": "10.1007/s12975-026-01502-0",
  "fulltext_url": "https://europepmc.org/articles/PMC13658293",
  "id": "2h7vhgfndze4t",
  "issns": [
    "1868-4483",
    "1868-601X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42864557",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Acute Ischemic Stroke Management"
    ]
  ],
  "openalex": "W7221549497",
  "pdf_url": "https://europepmc.org/articles/PMC13658293?pdf=render",
  "pmcid": "PMC13658293",
  "pmid": "42864557",
  "published": "2026-10-13",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2h7vhgfndze4t.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42864557",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42864557"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Acute Ischemic Stroke Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Acute Ischaemic Stroke: Therapeutic Targets and Key Modulators of the Fibrinolytic System and Clot Formation.",
  "title_text": "Acute Ischaemic Stroke: Therapeutic Targets and Key Modulators of the Fibrinolytic System and Clot Formation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:00Z",
  "url": "https://research.draconitic.com/paper/2h7vhgfndze4t",
  "venue": "Translational stroke research",
  "versions": []
}