Coagulation-fibrinolysis abnormalities in patients receiving antiparkinsonian agents.
Neuroleptic malignant syndrome (NMS) is induced by alteration of medication in Parkinson's disease (PD); and blood coagulation disorder is regarded as one of the mechanisms implicated in NMS. We have studied markers of blood coagulation and fibrinolysis in 270 patients with PD and 159 healthy controls matched in age and gender. The average values of prothrombin time (international normalized ratio) and plasma levels of prothrombin fragment(1+2), D-dimer, plasmin-alpha 2 antiplasmin complex, thrombomodulin and E-selectin were higher in patients receiving antiparkinsonian agents as compared to the patients without any medication or healthy controls. The effect of antiparkinsonian drugs was analyzed by dividing the patients into three groups according to the medication: the patients under the combination therapy with levodopa and a dopamine agonist, the patients administered levodopa, and those that received a dopamine agonist. Of the three groups, the patients under the combination therapy had the highest values of these markers, and those treated with only levodopa had the lowest values. PD patients receiving antiparkinsonian drugs are often associated with blood coagulation abnormalities, and plasma hemostatic markers should be routinely assessed in the management of such patients. Further study is needed to determine whether these abnormalities predispose to the development of NMS.
Sato
Yoshihiro
Y
Department of Rehabilitation Medicine, Institute of Brain Science, Hirosaki University School of Medicine, Hirosaki 036-8562, Japan. y-sato@ktarn.or.jp
Kaji
Masahide
M
Metoki
Norifumi
N
Yoshida
Hidemi
H
Satoh
Kei
K
D000368:Aged; D000933:Antifibrinolytic Agents / Q000097:blood; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000378:metabolism; D016022:Case-Control Studies; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019040:E-Selectin / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D005341:Fibrinolysin; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D019934:International Normalized Ratio / Q000379:methods; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology / Q000378:metabolism; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood; D011516:Prothrombin; D018180:Thrombomodulin / Q000097:blood; D000979:alpha-2-Antiplasmin
D000933:Antifibrinolytic Agents; D000978:Antiparkinson Agents; D015259:Dopamine Agents; D019040:E-Selectin; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D018180:Thrombomodulin; D000979:alpha-2-Antiplasmin; C036309:fibrin fragment D; C037742:plasmin-plasmin inhibitor complex; C045879:prothrombin fragment 1.2; D007980:Levodopa; D011516:Prothrombin; D005341:Fibrinolysin