Bleeding Time and Other Laboratory Tests To Monitor the Safety and Efficacy of Thrombolytic Therapy

¹ The Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston.

Widespread use of thrombolytic agents in a variety of settings has highlighted the need for measures of safety and efficacy. Previously used laboratory parameters, such as decreasing levels of fibrinogen and increasing levels of fibrin(ogen) degradation products (FDPs), have failed to correlate consistently with hemorrhagic events and have not yet been useful in predicting patients at risk for bleeding. Although the bleeding time (BT) has been considered primarily to reflect platelet function, it also reflects the interaction of platelets with vessel wall and coagulation pathways. Recently, the BT has been considered as a potential predictor of clinical bleeding during thrombolysis. The BT, as a measure of in vivo hemostatic competence, may be particularly well-suited for this application. Serial BTs during thrombolytic therapy may provide valuable information regarding safety and efficacy, but further studies are needed to confirm preliminary findings.