Thrombin activatable fibrinolysis inhibitor and clot lysis time in pregnant patients with antiphospholipid syndrome: relationship with pregnancy outcome and thrombosis.
OBJECTIVE
Antiphospholipid syndrome (APS) pregnancies are associated with thrombotic obstetric complications, despite treatment. This study evaluated Thrombin Activatable Fibrinolysis Inhibitor (TAFI) levels, TAFI gene polymorphisms and Clot Lysis Time (CLT) in pregnant patients with APS in relation to pregnancy outcome and thrombosis.


METHODS
Group 1 consisted of 67 pregnant patients with APS. Group 2 included 66 pregnant patients with uneventful term pregnancies and delivery. Patients were sampled during each trimester and at baseline. TAFI antigen and CLT and two polymorphisms of the TAFI gene, Ala147Thr and +1542C/G, were determined.


RESULTS
Significantly prolonged CLT was found at baseline in Group 1. Allele distribution of the TAFI gene polymorphisms was similar in both groups. Basal TAFI and CLT in patients with APS having an adverse or a good obstetrical outcome were similar. Comparison of TAFI and CLT baseline levels in patients with APS with or without previous thrombosis showed no statistical differences.


CONCLUSIONS
Patients with APS have impairment in fibrinolysis evidenced by prolonged CLT at baseline. TAFI and CLT do not seem to be useful as markers of obstetric outcome or risk of thrombosis in patients with APS.
Martinez-Zamora
Maria Angeles
MA
Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel, 170. 08036 - Barcelona, Spain.
Tassies
Dolors
D
Carmona
Francisco
F
Espinosa
Gerard
G
Cervera
Ricard
R
Reverter
Juan Carlos
JC
Balasch
Juan
J
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000235:genetics / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D001760:Bleeding Time; D025901:Carboxypeptidase B2 / Q000235:genetics / Q000378:metabolism*; D005260:Female; D005787:Gene Frequency; D006801:Humans; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D011256:Pregnancy Outcome; D013927:Thrombosis / Q000276:immunology
D025901:Carboxypeptidase B2