Changes in the plasma concentration of soluble thrombomodulin in patients with severe carotid artery stenosis after eversion endarterectomy.
OBJECTIVE
The purpose of the study was to investigate the putative role of soluble thrombomodulin (sTM) in severe carotid artery stenosis.


METHODS
We prospectively studied 64 patients who were undergoing carotid endarterectomy (2001-2003). Plasma sTM concentration was determined in each patient before surgery and at 14 months postsurgery. -308 TNF-alpha promoter polymorphism was also determined.


RESULTS
Strong negative correlation was found between the preoperative duplex scan values and the plasma sTM concentrations (R = -0.418, p = 0.0006). Patients with 308 A TNF-alpha genotype had significantly lower (p = 0.0415) preoperative sTM values than their counterparts with no such polymorphism. Soluble TM concentrations measured in plasma samples taken at the end of the postsurgical follow-up period of 14 months duration were significantly higher compared to the preoperative values (p < 0.0001).


CONCLUSIONS
Our present findings indicate that sTM may be adsorbed to the atherosclerotic plaques or inflamed endothelium in carotid arteries. The pathological significance of this adsorption remains to be determined.
Dósa
E
E
3rd Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Kútvölgyi út 4, 1125 Budapest, Hungary.
Szabó
A
A
Prohászka
Z
Z
Karádi
I
I
Rugonfalvi-Kiss
S
S
Apor
A
A
Járányi
Z
Z
Hüttl
K
K
Selmeci
L
L
Acsády
G
G
Füst
G
G
Entz
L
L
D000327:Adsorption; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D001161:Arteriosclerosis / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D016893:Carotid Stenosis / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D015536:Down-Regulation; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011184:Postoperative Period; D011401:Promoter Regions, Genetic; D012907:Smoking; D018180:Thrombomodulin / Q000097:blood* / Q000378:metabolism; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics / Q000378:metabolism
D018180:Thrombomodulin; D014409:Tumor Necrosis Factor-alpha