title: [Thrombin-activated inhibitor of fibrinolysis and efficacy and safety of long-term warfarin treatment in patients with venous thromboembolic complications].
abstract: OBJECTIVE
  To study effects of thrombin-activated fibrinolysis inhibitor (TAFI) on efficacy and safety of long-term anti-coagulant treatment in patients with venous thromboembolic complications (VTEC).
  
  
  METHODS
  A total of 111 patients with a history of an episode of deep vein thrombosis (DVT) and/or pulmonary artery thromboembolism (PATE) entered the study. All the patients received unfractionated or low-molecular heparin for at least 5 days than switch on warfarin (target values of INR 2.0-3.0). Baseline blood levels of TAFI were measured. The patients were followed up for 18 months. Recurrent (DVT/TAFI and hemorrhagic complications (HC) were endpoints. Also, frequency of complete lysis of deep vein thrombi was assessed after 12 months of treatment.
  
  
  RESULTS
  A TAFI level varied from 50 to 217% (median 106%, interquartile rage 90-133%). TAFI concentration positively correlated with fibrinogen and thromb size. The patients were divided into two groups depending on TAFI content: group 1 patients had low TAFI (under 25th percentile; < 90%); patients of group 2 had high TAFI (above 25th percentile; > 90%). Group 1 patients were characterized by less stable anticoagulation. This association did not depend on genetic characteristics which determine sensitivity to warfarin (CYP2C9 and VKORC1). Low TAFI was associated with reduced risk of DVT for 18 months and higher probability of complete lysis of the thrombi after 12 months of anticoagulant therapy compared to VTEC patients with high TAFI. No differences were found by TAFI level in patients with HC and without HC, but in HC patients low TAFI was associated with spontaneous hemorrhages and bleeding in therapeutic INR values.
  
  
  CONCLUSIONS
  The results of this pilot study evidence that a TAFI level can be one of the factors influencing efficacy and safety of long-term anticoagulant therapy in patients with VTEC on warfarin treatment.
authors.forename: N M
authors.initials: NM
authors.lastname: Vorob'eva
authors.forename: E P
authors.initials: EP
authors.lastname: Panchenko
authors.forename: A B
authors.initials: AB
authors.lastname: Dobrovol'skiĭ
authors.forename: E V
authors.initials: EV
authors.lastname: Titaeva
authors.forename: O V
authors.initials: OV
authors.lastname: Ermolina
authors.forename: T V
authors.initials: TV
authors.lastname: Balakhonova
authors.forename: Z B
authors.initials: ZB
authors.lastname: Khasanova
authors.forename: A Iu
authors.initials: AIu
authors.lastname: Postnov
authors.forename: A I
authors.initials: AI
authors.lastname: Kirienko
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D025901:Carboxypeptidase B2 / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000201:enzymology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010865:Pilot Projects; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D012044:Regression Analysis; D012306:Risk; D013997:Time Factors; D020246:Venous Thrombosis / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D025901:Carboxypeptidase B2