title: The role of hypercoagulability in ischemic colitis.
abstract: OBJECTIVE
  The aim of this study is to evaluate the role of thrombophilia-hypercoagulability in ischemic colitis (IC).
  
  
  METHODS
  Thrombophilia and fibrinogen were evaluated in 56 cases of IC and 44 controls with known predisposing factors but no evidence of IC. Thrombophilic factors tested were: protein C (PC), protein S, antithrombin (AT), resistance to activated protein C (APCR), lupus anticoagulant (LA), factor V G1691A mutation (FV Leiden), prothrombin G20210A mutation, methylenetetrahydrofolate reductase (MTHFR) gene C677T and A1298C mutations and plasminogen activator inhibitor-1 (PAI-1) gene 5G/4G and 4G/4G polymorphisms.
  
  
  RESULTS
  In IC group were recorded: i) low levels of PC and AT (p = 0.064 and p = 0.022, respectively); ii) low levels of APCR (normal: >2, p = 0.008); iii) high levels of fibrinogen (p = 0.0005); iv) higher number of homozygotes for MTHFR A1298C and C677T mutations (p = 0.061 and p = 0.525 (Pearson chi-square), respectively); v) greater prevalence of 5G/4G and 4G/4G polymorphisms (p = 0.031 (Pearson chi-square)) and vi) higher incidence of LA-positive individuals (p = 0.037, Fischer's exact test). Multivariate analysis was performed to determine the effects of prothrombotic factors in IC. 5G/4G polymorphism of PAI-1 gene (odds ratio (OR) 12.29; 95% confidence interval (CI) 2.26-67.00), APCR (OR 0.089; 95% CI 0.011-0.699) and fibrinogen (OR 1.013; 95% CI 1.003-1.023) were determined as predictors of IC.
  
  
  CONCLUSIONS
  This study suggests that hypercoagulability, hereditary or acquired, plays an essential role in the manifestation of IC.
authors: Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.
authors: Achilleas G
authors: AG
authors: Tsimperidis
authors: Andreas N
authors: AN
authors: Kapsoritakis
authors: Ioanna A
authors: IA
authors: Linardou
authors: Athanassios K
authors: AK
authors: Psychos
authors: Athanassios A
authors: AA
authors: Papageorgiou
authors: Nikos C
authors: NC
authors: Vamvakopoulos
authors: Despina S
authors: DS
authors: Kyriakou
authors: Spyros P
authors: SP
authors: Potamianos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017091:Colitis, Ischemic / Q000188:drug therapy / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006115:Greece; D006720:Homozygote; D006801:Humans; D016015:Logistic Models; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D019851:Thrombophilia / Q000235:genetics*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)
keywords: activated protein C resistance; antithrombin III deficiency; fibrinogen; ischemic colitis; protein C deficiency; protein S deficiency; thrombophilia