Data on the correlation between hemostatic parameters before treatment start, and markers of fibrinolysis during treatment in patients with acute pulmonary embolism, undergoing ultrasound-assisted catheter-directed thrombolysis

Personalized medicine is nowadays increasingly being used to tailor therapies to the individual needs of patients. We recently demonstrated, that various fibrinolytic parameters, including the plasma-based inducible plasmin-antiplasmin (plap) complex, as well as viscoelastic parameters, predict the individual treatment response in patients with intermediate- or high-risk pulmonary embolism (PE), treated with ultrasound-assisted catheter-directed thrombolysis (USAT). Markers of fibrinolysis and coagulation were assessed before the start of treatment (t0) and during the 10 - 15-hour infusion of recombinant tissue-type plasminogen activator (rt-PA) (t6). While we have already provided evidence of the predictive value of the assessed parameters for efficacy outcomes, in this article we present data on the correlation between these predictive markers and the endogenous fibrinolytic response during USAT. These data confirm the predictive value of the identified pre-treatment parameters for the endogenous treatment response, which may be important for their potential usefulness in modulating treatment decisions and dose adjustments in USAT for PE in the future.

个性化医疗（Personalized medicine）当下正日益广泛地应用于针对患者个体需求定制治疗方案。我们此前的研究已证实，多项纤溶参数——包括基于血浆的可诱导纤溶酶-抗纤溶酶（plasmin-antiplasmin, plap）复合物以及黏弹性参数——可预测中高危肺栓塞（pulmonary embolism, PE）患者接受超声辅助导管定向溶栓术（ultrasound-assisted catheter-directed thrombolysis, USAT）后的个体治疗应答。我们在治疗启动前（t0）以及重组组织型纤溶酶原激活剂（recombinant tissue-type plasminogen activator, rt-PA）10至15小时输注期间（t6），对纤溶与凝血标志物进行了检测。此前我们已验证了上述评估参数对疗效结局的预测价值，而本文则呈现了这些预测标志物与USAT过程中内源性纤溶应答之间的相关性数据。本研究数据证实了所确定的治疗前参数对患者内源性治疗应答的预测价值，该价值或可为未来指导肺栓塞患者USAT的治疗决策制定与剂量调整提供潜在的应用参考。