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March 1963

Induced Fibrinolytic Activity and Hypofibrinogenemia: Effect of Epsilon-Amino-Caproic Acid

Author Affiliations

Chemist, Research Laboratory, Veterans Administration Hospital (Mr. Belko); Chief, Surgical Service, Veterans Administration Hospital, and Clinical Professor of Surgery, Harvard Medical School (Dr. Warren).; From the Department of Surgery, Harvard Medical School and the Surgical Service, Veterans Administration Hospital.

Arch Surg. 1963;86(3):396-401. doi:10.1001/archsurg.1963.01310090046009

The introduction of therapeutic preparations that produce a fibrinolytic state has created a need for a neutralizing agent or inhibitor that can be used in any emergency in the event of hemorrhage resulting from over-dosage of the drugs or hypersensitivity to them.

In 1953, De Vries6 demonstrated the activity of amino acids as inhibitors of fibrinolytic activity. In 1959 Okamoto and his co-workers15 published an account of their earlier discovery of ε-amino-caproic acid (EACA) as a potent inhibitor of fibrinolysis. They named the product Ipsilon.5,21 Sarker,19 Sjoerdsma,20 Ablondi,2 and Alkjaersig3 substantiated these findings.

The mechanism of inhibition of lysis by ε-amino-caproic acid has been shown to be one of preventing the activation of plasminogen rather than the neutralization of fibrinolytic activity of plasmin.1-3,10,8

The creation of a bleeding state in dogs by the use of plasmin or an activator, and its subsequent

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