Increased thrombogenesity in patients with cyanotic congenital heart disease.
BACKGROUND
The basic mechanisms of thromboembolism in cyanotic congenital heart disease (CCHD) have not been well clarified. P-selectin on the platelets reflects platelet activation. Thrombomodulin is a critical cofactor for thrombin-mediated activation of protein C and reflects the anticoagulant activity of the endothelium. The present study was performed to evaluate whether platelet activation exists in patients with CCHD.


RESULTS
Platelet P-selectin as a marker of platelet activation, plasma thrombomodulin level and protein C activity as markers of anticoagulant activity of the endothelium and thrombin - antithrombin complex III (TAT) were examined in 35 patients with CCHD. Plasma thrombomodulin level (1.1+/-0.9 vs 2.2+/-0.3 FU/ml) and protein C activity (71.1+/-29.8 vs 117.8+/-24.8%) were significantly lower in patients with CCHD as compared with the control subjects. The levels of plasma TAT (255+/-811 vs 1.9+/-0.9 ng/ml) and P-selectin on platelets (6.3 +/-4.5 vs 3.3+/-0.3 mean fluorescence intensity) were significantly higher in the patients with CCHD than in the controls. Four of the CCHD patients who experienced thromboembolic events had elevated levels of platelet P-selectin (p=0.02) compared with CCHD patients without thromboembolic events.


CONCLUSIONS
Platelet activation exists in patients with CCHD and it may play an important role in the thromboembolic events in CCHD.
Kajimoto
Hidemi
H
Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Nakazawa
Makoto
M
Murasaki
Kagari
K
Mori
Yoshiki
Y
Tanoue
Kenjiro
K
Kasanuki
Hiroshi
H
Nakanishi
Toshio
T
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood* / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D019007:P-Selectin / Q000097:blood*; D015539:Platelet Activation; D011486:Protein C / Q000032:analysis*; D013917:Thrombin / Q000032:analysis*; D013923:Thromboembolism / Q000097:blood / Q000209:etiology; D018180:Thrombomodulin / Q000097:blood*
D015415:Biomarkers; D019007:P-Selectin; D011486:Protein C; D018180:Thrombomodulin; D013917:Thrombin