The coagulation and protein C pathways in patients with sleep apnea.
Patients with obstructive sleep apnea (OSA) have a high frequency of cardiovascular diseases and hypercoagulability is believed to be involved in the mechanism of those vascular events. We evaluated whether there is a dysfunction in the protein C anticoagulant pathway in patients with obstructive sleep apnea. Two hundred ninety-three patients were enrolled. To confirm the diagnosis of OSA, all-night polysomnography, including determination of SpO(2), was carried out. The apnea-hypopnea index (AHI) was used for judging the presence of sleep-breathing disorder. The plasma levels of the thrombin-antithrombin complex were higher in patients with AHI > 5 than in those without OSA, defined as AHI < 5. However, there was no statistically significant difference in the plasma level of either activated protein C/alpha-antitrypsin complex or soluble thrombomodulin between patients with AHI > 5 and those with AHI < 5. The results of this study showed for the first time that markers of the protein C anticoagulant pathway are not affected in patients with OSA and that the protein C pathway is probably not involved in the mechanism of hypercoagulability in subjects with sleep-disordered breathing.
Takagi
Takehiro
T
Department of Pulmonary and Critical Care Medicine, Mie University Graduate School of Medicine, Tsu-city, Mie, Japan.
Morser
John
J
Gabazza
Esteban C
EC
Qin
Liqiang
L
Fujiwara
Atsushi
A
Naito
Masaki
M
Yamaguchi
Aiko
A
Kobayashi
Tetsu
T
D'Alessandro-Gabazza
Corina N
CN
Boveda Ruiz
Daniel
D
Gil Bernabe
Paloma
P
Iwasaki
Yasuhiko
Y
Takei
Yoshiyuki
Y
Taguchi
Osamu
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D017286:Polysomnography; D011486:Protein C / Q000378:metabolism*; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D018180:Thrombomodulin / Q000097:blood; D013927:Thrombosis / Q000097:blood / Q000209:etiology*; D055815:Young Adult; D000515:alpha 1-Antitrypsin / Q000097:blood
D015415:Biomarkers; D011486:Protein C; D018180:Thrombomodulin; D000515:alpha 1-Antitrypsin; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases