Evaluation of overall fibrinolytic activity in patients with coronary artery ectasia: Global fibrinolytic capacity

Doğan, Abdullah; Tunç, Bahattin; Ergene, Oktay; Özaydın, Mehmet; Nazli, Cem; Altınbaş, Ahmet; Gedikli, Omer

doi:10.1023/b:caim.0000004339.30038.8d

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…Global fibrinolytic capacity was found to be significantly higher in ectatic patients than in controls. 9 However, it remains unclear whether specific changes in the coagulation/fibrinolytic system resulted in or from CAE. The objective of this study is to further investigate the process of thrombus formation and degradation in CAE patients.…”

Section: Introductionmentioning

confidence: 99%

Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia

Liu

Chen

et al. 2016

Medicine

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Thrombus formation and myocardial infarction are not uncommon in patients with coronary artery ectasia (CAE). In light of this, the present study aims to systemically evaluate the blood coagulation and fibrinolytic systems in CAE patients. In this study, we enrolled 30 patients with CAE, 30 patients with coronary atherosclerosis disease (CAD), and 29 subjects with normal coronary arteries (control). The coagulation system was evaluated using a routine coagulation function test performed in the hospital laboratory before coronary angiography, and measurements included prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen time, and thrombin time. The evaluation of the fibrinolytic system included measurements of D-dimer, euglobulin lysis time, plasminogen activator inhibitor 1, plasminogen, plasminogen activity assay, α1-antitrypsin (α1-AT), α2 plasmin inhibitor (α2-PI), and α2-macroglobulin (α2-MG). Alpha1-AT, α2-PI, and α2-MG also inhibit activities of 3 neutrophil serine proteases, namely human neutrophil elastase (HNE), cathepsin G (CG), and proteinase 3 (PR3); therefore, the plasma levels of these 3 proteinases were also evaluated.In CAE patients, the circulating coagulation system was normal. For the fibrinolytic system, a decrease of plasminogen activity was observed (P = 0.029) when compared with CAD patients, and the concentrations of α1-AT (both P < 0.001), α2-PI (P = 0.002 and P = 0.025), and α2-MG (P = 0.034 and P < 0.001) were significantly elevated when compared with CAD patients and normal controls. Moreover, the plasma levels of HNE (both P < 0.001) and CG (P = 0.027 and 0.016) in CAE patients were also significantly higher than those of the CAD and control groups. There was no difference in plasma PR3 concentration among these 3 groups.Disequilibrium of the coagulation/fibrinolytic system may contribute to thrombus formation and clinical coronary events in patients with CAE. The increased plasma concentrations of α1-AT, α2-PI, and α2-MG might provide beneficial effects by inhibiting the proteinases and restraining the ectatic process; on other hand, they led to unfavorable results by inhibiting plasmin and decreasing thrombus degradation in CAE patients.

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Section: Introductionmentioning

confidence: 99%

Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia

Liu

Chen

et al. 2016

Medicine

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“…2 –22 It may appear as a relatively innocent clinical entity; however, it can cause cardiac events such as stable or unstable angina pectoris, myocardial infarction, and cardiac death. 23 –25 Several studies have shown that patients with isolated CAE have an increased risk of mortality, equivalent to that of patients with obstructive CAD. 3 –5 In the current study, plasma sCD40L level is similar within CAE and CAD patient groups.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Plasma Levels of Soluble CD40 Ligand and the Presence and Severity of Isolated Coronary Artery Ectasia

Özde

Korkmaz

Kundi

et al. 2016

Clin Appl Thromb Hemost

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“…GFC is sensitive to all the factors involved in the process of fibrinolysis [12][13][14][15][16][17][18]. To our knowledge, GFC has not previously been tested in HSCT, although it has been used for the detection of fibrinolytic response in a variety of clinical (pro)thrombotic states [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The aim of this study is to serially assess GFC at the critical points (days À1, þ7, þ14, þ21 following transplantation) during the course of HSCT.…”

Section: Introductionmentioning

confidence: 99%

Unchanged global fibrinolytic capacity during the course of hematopoietic stem cell transplantation

Aksu

Beyazıt²,

Haznedaroğlu³

et al. 2006

Blood Coagulation &Amp; Fibrinolysis

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Hemostatic changes due to vascular endothelial damage are seen during the course of hematopoietic stem cell transplantation (HSCT). The fibrinolytic response to ongoing hemostatic activation in HSCT remains to be elucidated. Global fibrinolytic capacity (GFC) is a novel method, which reflects the amount of generated D-dimer when fibrinolysis of a freeze-dried fibrin clot is stopped by introducing aprotinin. GFC is sensitive to all the factors involved in the process of fibrinolysis. The aim of this study was to serially assess GFC at certain critical time points (days -1, +7, +14, +21 prior to and following stem cell infusion) during the course of HSCT. The study group comprised 16 patients with hematological malignancies (11 women, five men; median age 32+/-9 years) in whom HSCT had been performed. Thirty healthy adults (21 women, nine men; median age 31+/-7 years) served as controls. In this study, global fibrinolytic response, as reflected by GFC, was unchanged despite ongoing hemostatic activation, as indicated by D-dimer, moreover GFC remained stable, despite the development of thrombocytopenia associated with HSCT prior to platelet engraftment. Our results indicate that a global fibrinolytic response was impaired as a compensatory response to endothelial activation and to other hemostatic changes seen in HSCT. Further studies in larger HSCT populations are warranted to better understand the implications of these findings.

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Evaluation of overall fibrinolytic activity in patients with coronary artery ectasia: Global fibrinolytic capacity

Abstract: Our results suggest that fibrinolytic system activation may develop in ectasia patients with acute coronary syndrome. It can be induced by thrombus formation in ectatic segment of coronary artery.

Cited by 7 publications

References 23 publications

Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia

Disequilibrium of Blood Coagulation and Fibrinolytic System in Patients With Coronary Artery Ectasia

Relationship Between Plasma Levels of Soluble CD40 Ligand and the Presence and Severity of Isolated Coronary Artery Ectasia

Unchanged global fibrinolytic capacity during the course of hematopoietic stem cell transplantation

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