{
  "abstract": "Background: Patients with primary immune thrombocytopenia (ITP) have an increased risk of thrombosis, which may be due to altered fibrinolysis.\n\nObjectives: To elucidate the clinical impact of delayed fibrinolysis in ITP patients.\n\nMethods: A turbidimetric clot formation and lysis assay and a fluorometric plasmin generation (PG) assay were performed, and levels of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA), tPA-PAI-1 complexes, α2-antiplasmin, thrombin activatable fibrinolysis inhibitor, and D-dimer were assessed in 86 adult primary ITP patients and 78 healthy controls (HCs).\n\nResults: ITP patients showed significantly delayed clot formation, increased clot density, and prolonged clot lysis time (CLT) compared with HCs, with a median (IQR) CLT of 28.0 (13.7-34.7) minutes in patients and 17.3 (12.0-28.0) minutes in HCs, while in the PG assay, only the lag time was prolonged. In ITP patients compared with controls, PAI-1 was higher (1.2 [0.8-2.6] vs 1.1 [0.6-2.1] U/mL) and tPA antigen and activity were lower (tPA antigen: 2.6 [1.1-4.4] vs 3.7 [3.2-4.7] ng/mL; tPA activity ≤ 0 U/mL: 26% vs 7%). TPA-PAI-1 complex levels were positively associated with CLT in multiple linear regression analysis (β = 0.241; P = .019), whereas PG parameters were not associated with CLT. Six patients who developed thrombosis during follow-up had higher levels of tPA-PAI-1 complexes.\n\nConclusion:Prolonged CLT and delayed onset of PG may indicate a hypofibrinolytic tendency in ITP patients, as also indicated by high PAI-1 and low tPA levels. No association was found between fibrinolytic potential and the bleeding phenotype, whereas higher tPA-PAI-1 complex levels were associated with prolonged CLT and increased in patients with future thrombosis.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "name": "Theresa Schramm"
    },
    {
      "name": "Jasmin Rast"
    },
    {
      "name": "Dino Mehic"
    },
    {
      "name": "Stéphanie E Reitsma"
    },
    {
      "name": "Claire de Moreuil"
    },
    {
      "name": "Michael Fillitz"
    },
    {
      "name": "Peter Quehenberger"
    },
    {
      "name": "Bas de Laat"
    },
    {
      "name": "Alisa S Wolberg"
    },
    {
      "name": "Cihan Ay"
    },
    {
      "name": "Ingrid Pabinger"
    },
    {
      "name": "Johanna Gebhart"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5xmhwgbkckvqk.bib",
  "cited_by": 7,
  "doi": "10.1016/j.jtha.2024.07.034",
  "fulltext_url": null,
  "id": "5xmhwgbkckvqk",
  "issns": [
    "1538-7933",
    "1538-7836"
  ],
  "landing_url": "https://univ-brest.hal.science/hal-05745841v1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2720|Platelet Disorders and Treatments"
    ]
  ],
  "openalex": "W4401945296",
  "pdf_url": "https://univ-brest.hal.science/hal-05745841/document",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-10",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/5xmhwgbkckvqk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:33Z",
      "native_id": "hal-05745841",
      "source": "hal",
      "url": "https://univ-brest.hal.science/hal-05745841v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    }
  ],
  "title": "Fibrinolysis is impaired in patients with primary immune thrombocytopenia",
  "title_text": "Fibrinolysis is impaired in patients with primary immune thrombocytopenia",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:33Z",
  "url": "https://research.draconitic.com/paper/5xmhwgbkckvqk",
  "venue": "Journal of Thrombosis and Haemostasis",
  "versions": []
}