title: The association between the 4G/5G polymorphism in the promoter of the plasminogen activator inhibitor-1 gene and extension of postsurgical calf vein thrombosis.
abstract: The objective of this study was to evaluate whether the presence of a plasminogen activator inhibitor type 1 (PAI-1) promoter polymorphism 4G/5G could significantly influence the proximal extension of vein thrombosis in spite of anticoagulant treatment in patients with calf vein thrombosis (CVT) following orthopaedic, urological and abdominal surgery. We studied 168 patients with CVT, who had undergone orthopaedic, urological and abdominal surgery, subdivided as follows: first, 50 patients with thrombosis progression; second, 118 patients without thrombosis progression. The 4G/5G polymorphism of the plasminogen activator inhibitor 1 was evaluated in all patients and in 70 healthy matched controls. We also studied PAI-1 activity in plasma. The presence of 4G/5G genotype was significantly increased in the group of patients with the extension of thrombotic lesions and was associated with an increase in CVT extension risk (odds ratio adjusted for sex 2.692; 95% confidence interval 1.302-4.702). Moreover, we observed a significant increase of PAI-1 plasma activity in patients with extension of thrombotic lesion vs. patients without extension (P=0.0001). Patients with 4G/5G genotype in the promoter of the plasminogen activator inhibitor - 1 gene present a higher risk of extension of thrombotic lesions.
authors.affiliation: Department of Internal Medicine, Cardiovascular and Nephro-urogical Diseases, University Medical Hospital, Palermo, Italy. f_ferrara@virgilio.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Ferrara
authors.forename: Francesco
authors.initials: F
authors.lastname: Meli
authors.forename: Francesco
authors.initials: F
authors.lastname: Raimondi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Montalto
authors.forename: Valentina
authors.initials: V
authors.lastname: Cospite
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
mesh_terms: D000368:Aged; D000483:Alleles; D016022:Case-Control Studies; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic; D011183:Postoperative Complications / Q000235:genetics* / Q000473:pathology; D011401:Promoter Regions, Genetic; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology / Q000235:genetics* / Q000473:pathology
chemical_list: D017395:Plasminogen Activator Inhibitor 1