title: Fibrinolytic variables in patients with recurrent venous thrombosis: a prospective cohort study.
abstract: To determine whether fibrinolytic testing predicts recurrent venous thrombosis, we have performed a prospective cohort study in which 303 patients with a first episode of venous thromboembolism underwent comprehensive fibrinolytic testing while receiving oral anticoagulants, and after anticoagulants had been discontinued. They were then followed for up to 3 years for recurrent venous thrombosis. No systematic differences in the levels or activity of type 1 plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (tPA) or euglobulin clot lysis times were detected between patients who did, or did not, suffer recurrent thrombosis. There were also no differences in these variables when patients whose initial thrombosis was idiopathic were compared to patients whose thrombosis occurred in the setting of a known thrombotic risk factor. Based on these results, neither measuring fibrinolytic parameters in patients with venous thromboembolism, nor modification of treatment based on the results of such testing, are justified. Our study also confirms that patients with idiopathic venous thromboembolism have a high risk of recurrence.
authors: Hamilton Civic Hospitals Research Centre, Henderson General Hospital, ON, Canada. crowthrm@fhs.csu.mcmaster.ca
authors: M A
authors: MA
authors: Crowther
authors: J
authors: J
authors: Roberts
authors: R
authors: R
authors: Roberts
authors: M
authors: M
authors: Johnston
authors: P
authors: P
authors: Stevens
authors: P
authors: P
authors: Skingley
authors: G M
authors: GM
authors: Patrassi
authors: M T
authors: MT
authors: Sartori
authors: J
authors: J
authors: Hirsh
authors: P
authors: P
authors: Prandoni
authors: J I
authors: JI
authors: Weitz
authors: M
authors: M
authors: Gent
authors: J S
authors: JS
authors: Ginsberg
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D010959:Tissue Plasminogen Activator / Q000097:blood; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D005343:Fibrinolytic Agents; D017395:Plasminogen Activator Inhibitor 1; D010959:Tissue Plasminogen Activator