{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T02:25:35Z","timestamp":1791685535713,"version":"4.3.4"},"reference-count":221,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Fibrinolytic agents catalyze the conversion of the inactive proenzyme plasminogen into the active protease plasmin, degrading fibrin within the thrombus and recanalizing occluded vessels. The history of these medications dates to the discovery of the first fibrinolytic compound, streptokinase, from bacterial cultures in 1933. Over time, researchers identified two other plasminogen activators in human samples, namely urokinase and tissue plasminogen activator (tPA). Subsequently, tPA was cloned using recombinant DNA methods to produce alteplase. Several additional derivatives of tPA, such as tenecteplase and reteplase, were developed to extend the plasma half-life of tPA. Over the past decades, fibrinolytic medications have been widely used to manage patients with venous and arterial thromboembolic events. Currently, alteplase is approved by the U.S. Food and Drug Administration (FDA) for use in patients with pulmonary embolism with hemodynamic compromise, ST-segment elevation myocardial infarction (STEMI), acute ischemic stroke, and central venous access device occlusion. Reteplase and tenecteplase have also received FDA approval for treating patients with STEMI. This review provides an overview of the historical background related to fibrinolytic agents and briefly summarizes their approved indications across various thromboembolic diseases.<\/jats:p>","DOI":"10.1055\/s-0044-1781451","type":"journal-article","created":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T00:14:43Z","timestamp":1709338483000},"page":"773-789","source":"Crossref","is-referenced-by-count":17,"title":["Fibrinolytic Agents in Thromboembolic Diseases: Historical Perspectives and Approved Indications"],"prefix":"10.1055","volume":"50","author":[{"given":"Sina","family":"Rashedi","sequence":"additional","affiliation":[{"name":"Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie M.","family":"Greason","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parham","family":"Sadeghipour","sequence":"additional","affiliation":[{"name":"Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran"},{"name":"Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azita H.","family":"Talasaz","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Outcomes Sciences, Virginia Commonwealth University, Richmond, Virginia"},{"name":"Department of Pharmacy Practice, Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, New York, New York"},{"name":"Department of Pharmacy, New York-Presbyterian Hospital Columbia University Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"O'Donoghue","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, TIMI Study Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital Ram\u00f3n y Cajal (IRYCIS), Madrid, Spain"},{"name":"Medicine Department, Universidad de Alcal\u00e1 (IRYCIS), Madrid, Spain"},{"name":"CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Monreal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Spain"},{"name":"Universidad Catolica de Murcia, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Program in Medical and Population Genetics, Broad Institute of Harvard and the Massachusetts Institute of Technology, Boston, Massachusetts"},{"name":"McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S. V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M. Baumann","family":"Kreuziger","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"Blood Research Institute, Versiti, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Cardiology and Center of Cardiovascular Medicine, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Z.","family":"Goldhaber","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros V.","family":"Konstantinides","sequence":"additional","affiliation":[{"name":"Center for 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