Level of antithrombin III, protein C, protein S and other selected parameters of coagulation and fibrinolysis in the blood of the patients with recurrent deep venous thrombosis.
BACKGROUND
Thrombophilia is caused mainly by disturbances of hemostasis involving excessive coagulation system activation, reduction of anticoagulation system (antithrombin III, protein C, protein S, RAPC) or fibrinolytic activity.


METHODS
In 34 young patients (aged <40 years) with recurrent deep venous thrombosis (>2 incidents) the activity of antithrombin III, protein C, S, platelet count, adhesion and aggregation, APTT, stipven-kephalin, prothrombin time and INR were investigated. Fibrinogen, factor XIII, ELT, FDP, Ag t-PA levels, antigen concentration and PAI-1 activity were determined. Patients with idiopathic DVT, after elimination of most important thromboembolism risk factors, were qualified for the study. DVT was confirmed in all patients by phlebography, plethysmography and ultrasonography. Results were compared with a group of 54 healthy controls.


RESULTS
In almost 50% of patients with recurrent DVT (15/34) decrease of at least one plasma coagulation inhibitor (AT III, PC, PS) level was observed. In the patient group (with AT III and/or PC and/or PS decrease) statistically significant reduction of kaolin-kephalin time in comparison with controls was observed (a<0. 01). Analysis of fibrinolysis system demonstrated significant factor XIII level decrease (to 58.3%), fibrinogen level increase, ELT prolongation, and fibrinogen and fibrin degradation product increase in comparison with controls. The patients demonstrated 3-fold higher t-PA antigen level (13.1 ng/ml, a<0. 0001) and over 3-fold higher PAI-1 activity (26.7 AU/ml, a<0. 001) than healthy controls.


CONCLUSIONS
Reduced antithrombin III, protein C, protein S activity and excessive activation of the coagulation system with secondary fibrinolytic activity increase were found in patients with recurrent DVT.
Swiatkiewicz
Andrzej
A
Clinic of General Surgery, Medical University of Bydgoszcz, Poland.
Jurkowski
Piort
P
Kotschy
Maria
M
Ciecierski
Marek
M
Jawień
Arkadiusz
A
D000328:Adult; D000990:Antithrombin III / Q000032:analysis*; D001780:Blood Coagulation Tests; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D010979:Platelet Function Tests; D010991:Plethysmography; D011486:Protein C / Q000032:analysis*; D017293:Protein S / Q000032:analysis*; D012008:Recurrence; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000097:blood; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging
D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D011486:Protein C; D017293:Protein S; D000990:Antithrombin III; D010959:Tissue Plasminogen Activator