Deep vein thrombosis and fibrinolysis. Defective urokinase type plasminogen activator release.
In the present study 57 consecutive patients with a first episode of venographically proven deep vein thrombosis were investigated to evaluate the release of tissue-type plasminogen activator (t-PA) and of urokinase-type plasminogen activator (u-PA) in response to DDAVP stimulation as well as the resting plasminogen activator inhibitor (PAI) concentration, comparing this to the results obtained in 66 similar patients with a clinical suspicion of thrombosis but with a normal venogram. All assays were performed without knowledge of the patient's status. Four patients in the deep vein thrombosis-group (7%) had an absent u-PA antigen response upon DDAVP infusion, while a normal response was observed in all control subjects. Patients and controls showed similar increases in t-PA antigen level upon DDAVP. High resting PAI antigen levels were encountered in 5 patients in the deep vein thrombosis-group (9%) and in 6 subjects in the control group (9%). The results from this controlled study indicate that a defective release of u-PA may occur in patients with deep vein thrombosis and may have pathogenetic significance. Furthermore it is concluded that elevation of PAI levels cannot be considered as a specific risk factor for venous thrombosis.
Levi
M
M
Centre for Thrombosis, Haemostasis and Atherosclerosis Research, Academic Medical Center, Amsterdam, The Netherlands.
Lensing
A W
AW
Büller
H R
HR
Prandoni
P
P
Dooijewaard
G
G
Cuppini
S
S
ten Cate
J W
JW
D000941:Antigens / Q000097:blood; D003894:Deamino Arginine Vasopressin; D004797:Enzyme-Linked Immunosorbent Assay; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D015849:Plasminogen Inactivators / Q000276:immunology; D015995:Prevalence; D012016:Reference Values; D012189:Retrospective Studies; D013924:Thrombophlebitis / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000276:immunology; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood* / Q000276:immunology
D000941:Antigens; D015849:Plasminogen Inactivators; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator; D003894:Deamino Arginine Vasopressin