Increased plasma fibrinolysis and tissue-type plasminogen activator/tissue-type plasminogen activator inhibitor ratios after ethanol withdrawal in chronic alcoholics.
The effects of alcohol withdrawal on fibrinolysis were studied in 10 middle-aged male chronic alcoholics institutionalized for withdrawal therapy. All patients were sampled on admission [day 1 (D1)] and 21 days after alcohol withdrawal [day 22 (D22)]. The overall plasma fibrinolytic capacity (OFC) was assayed by measuring the ability of patient plasma to generate D-dimers from a standardized fibrin clot, and tissue-type plasminogen activator (t-PA) and t-PA inhibitor (PAI-1) levels were assayed together with serum cholesterol, triglyceride and cholesterol fractions. At D22, the OFC significantly increased in seven patients [D1 = 10 +/- 0.7 microg/h (mean +/- SD), D22 = 17 +/- 7.4 microg/h; P < 0.01], while t-PA and PAI-1 levels decreased in all patients but two (t-PA: D1 = 16.6 +/- 5 ng/ml, D22 = 10.2 +/- 3.8 ng/ml; P < 0.001; and PAI-1: D1 = 46 +/- 39 ng/ml, D22 = 21 +/- 28 ng/ml; P < 0.01). This study clearly demonstrates an increase in overall fibrinolytic activity after alcohol withdrawal, which is mainly due to a decrease in PAI-1 levels. These changes induced by alcohol abstinence might provide clear benefit by reducing the risk of thromboembolic events and particularly of stroke associated with elevated PAI-1 levels described in heavy drinkers.
Service d'Hématologie-Hémostase, H pital Trousseau, Tours, France.
B
B
Delahousse
F
F
Maillot
I
I
Gabriel
F
F
Schellenberg
F
F
Lamisse
Y
Y
Gruel
D000328:Adult; D000437:Alcoholism / Q000097:blood*; D000431:Ethanol / Q000009:adverse effects*; D005342:Fibrinolysis / Q000187:drug effects*; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015849:Plasminogen Inactivators / Q000097:blood*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013375:Substance Withdrawal Syndrome / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000037:antagonists & inhibitors / Q000097:blood*
D008055:Lipids; D015849:Plasminogen Inactivators; D000431:Ethanol; D010959:Tissue Plasminogen Activator