Plasminogen activator converts plasminogen to its active form, plasmin. B. Decreased plasminogen activator level C. Increased levels of fibrinolytic system inhibitors 1. Alpha 2 -antiplasmin 2. Impaired fibrinolysis is often a reactive process and is also often seen in the setting of acute myocardial infarction, gereralized atherosclerosis, diabetes, thrombotic thrombocytopenic purpura, deep venous thrombosis, pulmonary embolus, liver disease, post-operative state, scleroderma, and sepsis. Dysfunctional form is more common.
Venous thrombosis is common and begins in mid-late teenage years.
Arterial thrombotic events are rare. E. Must specifically assay plasminogen activity to make the diagnosis. F. aPT, aPTT, platelet count, thrombin time, and bleeding time are all normal. Warfarin for long-term anticoagulation 2. Heparin for acute thrombosis 3.