title: Tissue factor-dependent pathway in severe preeclampsia revisited: a Brazilian cohort study.
abstract: Previously we investigated the tissue factor (TF)-dependent coagulation pathway and key haemostatic cofactors in white women with preeclampsia (P-EC) and suggested that plasma factor VII (FVII) levels can differentiate women with P-EC from healthy nonpregnant women or normal pregnant women, at the same trimester, with high sensitivity, specificity, positive and negative predictive values. Here we re-examine the TF-dependent pathway in a large cohort of Brazilian women. A total of 240 women were studied. These included healthy nonpregnant women (n = 79), normotensive pregnant women (n = 80) and women with severe P-EC (n = 81). Commercially available enzyme-linked immunosorbent assays were used to measure plasma FVII, activated factor VII (FVIIa), TF and tissue factor pathway inhibitor (TFPI). All study participants were matched for age. Pregnant women (with/without P-EC) were matched for gestational age and parity. Plasma levels of FVII, FVIIa and TFPI were significantly increased in women with severe P-EC compared with healthy nonpregnant women (P < 0.01) or normotensive pregnant women (P < 0.01). FVIIa was also higher in normotensive pregnant women compared with nonpregnant women (P < 0.01). However, no such significant trends were observed for plasma TF levels (P = 0.074). In conclusion, circulating FVII, FVIIa and TFPI were significantly elevated in women with severe P-EC in the absence of comparable changes in plasma TF levels. The present work is in agreement with our previous report on FVII levels in white women with P-EC. Thus, this lends further support to the notion that plasma FVII levels are potentially valuable diagnostic marker for P-EC, irrespective of ethnicity.
authors.affiliation: aClinical and Toxicological Department, Faculty of Pharmacy, Federal University of Minas Gerais, BrazilbFaculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Luci M
authors.initials: LM
authors.lastname: Dusse
authors.forename: Lara C
authors.initials: LC
authors.lastname: Godoi
authors.forename: Karina B
authors.initials: KB
authors.lastname: Gomes
authors.forename: Maria das G
authors.initials: Md
authors.lastname: Carvalho
authors.forename: Bashir A
authors.initials: BA
authors.lastname: Lwaleed
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D001794:Blood Pressure; D001938:Brazil; D016022:Case-Control Studies; D015331:Cohort Studies; D005167:Factor VII / Q000235:genetics* / Q000378:metabolism; D015942:Factor VIIa / Q000235:genetics* / Q000378:metabolism; D005260:Female; D015870:Gene Expression; D006801:Humans; D008074:Lipoproteins / Q000097:blood / Q000235:genetics*; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D011247:Pregnancy; D012720:Severity of Illness Index; D013925:Thromboplastin / Q000235:genetics* / Q000378:metabolism
chemical_list: D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor; D005167:Factor VII; D013925:Thromboplastin; D015942:Factor VIIa