title: Endogenous thrombin potential in Behçet's disease: relationship with thrombosis and anticoagulant therapy.
abstract: OBJECTIVE
  To analyse the relationship between an automated thrombin generation test, the endogenous thrombin potential (ETP), and other hypercoagulability markers, with vascular involvement in patients with Behçet's disease (BD). Patients and methods. We analysed 56 BD patients (30 men; mean age, 34.4 ± 14.3 years) without any known thrombophilic factor, of which 17 had previously suffered from thrombosis (deep venous thrombosis in 14 and ischaemic stroke in 3), and 56 controls matched for age and sex. Additionally, we also evaluated 20 plasma samples with an international normalised ratio (INR) between 1.5 and 5.0 obtained from patients with atrial fibrillation but without a history of embolic events that were under treatment with acenocumarol. Thrombin generation was measured as ETP with a chromogenic assay in an automated analyser. Factor VIII, von Willebrand factor antigen, prothrombin fragment 1.2, D-dimer and plasmin-antiplasmin complexes were also measured.
  
  
  RESULTS
  BD patients showed higher ETP values than controls (471.3± 49.3 vs. 427.5± 31.3 mA; p<0.001). Additionally, BD patients with a history of thrombosis had higher ETP values than patients without thrombosis (496.6± 36.5 vs. 460.7± 50.5 mA; p<0.01). Factor VIII and von Willebrand factor antigen were also elevated in BD patients, but only von Willebrand factor antigen showed statistically significant differences between BD patients with and without thrombosis. Acenocumarol treatment reduced thrombin generation in BD patients in parallel to INR levels, reaching values similar to those of patients with atrial fibrillation and similar INR.
  
  
  CONCLUSIONS
  BD is associated with thrombosis, and increased thrombin generation (measured as ETP) is a promising marker of hypercoagulability.
authors: Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Catalonia, Spain. jcmejia@clinic.cat.
authors: Juan-Carlos
authors: JC
authors: Mejía
authors: Gerard
authors: G
authors: Espinosa
authors: Dolors
authors: D
authors: Tàssies
authors: Joan-Carles
authors: JC
authors: Reverter
authors: Ricard
authors: R
authors: Cervera
mesh_terms: D000074:Acenocoumarol / Q000627:therapeutic use; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001780:Blood Coagulation Tests; D002545:Brain Ischemia / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011516:Prothrombin / Q000378:metabolism; D013917:Thrombin / Q000378:metabolism*; D019851:Thrombophilia / Q000097:blood* / Q000175:diagnosis*; D020246:Venous Thrombosis / Q000097:blood* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D011516:Prothrombin; D013917:Thrombin; D000074:Acenocoumarol