title: Altered Hypercoagulability Factors in Patients with Chronic Chagas Disease: Potential Biomarkers of Therapeutic Response.
abstract: Thromboembolic events were described in patients with Chagas disease without cardiomyopathy. We aim to confirm if there is a hypercoagulable state in these patients and to determine if there is an early normalization of hemostasis factors after antiparasitic treatment. Ninety-nine individuals from Chagas disease-endemic areas were classified in two groups: G1, with T.cruzi infection (n = 56); G2, healthy individuals (n = 43). Twenty-four hemostasis factors were measured at baseline. G1 patients treated with benznidazole were followed for 36 months, recording clinical parameters and performance of conventional serology, chemiluminescent enzyme-linked immunosorbent assay (trypomastigote-derived glycosylphosphatidylinositol-anchored mucins), quantitative polymerase chain reaction, and hemostasis tests every 6-month visits. Prothrombin fragment 1+2 (F1+2) and endogenous thrombin potential (ETP) were abnormally expressed in 77% and 50% of infected patients at baseline but returned to and remained at normal levels shortly after treatment in 76% and 96% of cases, respectively. Plasmin-antiplasmin complexes (PAP) were altered before treatment in 32% of G1 patients but normalized in 94% of cases several months after treatment. None of the patients with normal F1+2 values during follow-up had a positive qRT-PCR result, but 3/24 patients (13%) with normal ETP values did. In a percentage of chronic T. cruzi infected patients treated with benznidazole, altered coagulation markers returned into normal levels. F1+2, ETP and PAP could be useful markers for assessing sustained response to benznidazole.
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Maria-Jesus
authors.initials: MJ
authors.lastname: Pinazo
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Elizabeth de Jesus
authors.initials: Ede J
authors.lastname: Posada
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Izquierdo
authors.affiliation: Hemotherapy and Hemostasis Department, Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Tassies
authors.affiliation: Border Biomedical Research Center, Department of Biological Sciences, University of Texas at El Paso, El Paso, Texas, United States of America.|Universidade Federal de Minas Gerais, Departamento de Parasitologia, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Alexandre-Ferreira
authors.initials: AF
authors.lastname: Marques
authors.affiliation: Health Biostatistics, ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: de Lazzari
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Edelweiss
authors.initials: E
authors.lastname: Aldasoro
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Muñoz
authors.affiliation: Laboratori de Parasitologia, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Abras
authors.affiliation: Laboratori de Parasitologia, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Tebar
authors.affiliation: Laboratori de Parasitologia, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain.|Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Gallego
authors.affiliation: Border Biomedical Research Center, Department of Biological Sciences, University of Texas at El Paso, El Paso, Texas, United States of America.
authors.forename: Igor Correia
authors.initials: IC
authors.lastname: de Almeida
authors.affiliation: Hemotherapy and Hemostasis Department, Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Reverter
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gascon
mesh_terms: D000293:Adolescent; D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D014355:Chagas Disease / Q000150:complications* / Q000188:drug therapy*; D002908:Chronic Disease / Q000188:drug therapy; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009593:Nitroimidazoles / Q000627:therapeutic use; D019851:Thrombophilia / Q000473:pathology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D015415:Biomarkers; D009593:Nitroimidazoles; C009999:benzonidazole