Fibrinogen and fibrinolytic activity in hyperthyroidism before and after antithyroid treatment

Marongiu, Francesco; Conti, Maria; Mameli, G.; Murtas, M L; Balzano, S.; Sorano, G.G.; Mamusa, Angela Maria; Martino, Enio

doi:10.1007/bf03350928

Cited by 38 publications

(28 citation statements)

References 10 publications

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“…Significantly increased serum thrombomodulin were found by Morikawa et al in patients with Graves' disease [16]. Increased fibrinogen values in hyperthyroidism were also observed in some [17][18][19][20], but not all of the studies [21].…”

Section: Discussionmentioning

confidence: 77%

Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients

Lippi

Franchini

Targher

et al. 2008

J Thromb Thrombolysis

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Although clinical evidence supports a plausible association between thyroid disorders and venous thrombosis, reliable evidence is so far lacking on the potential biological mechanisms and neither temporary nor permanent thromboembolic risk factors were constantly identified. We performed a 2-years retrospective analysis to retrieve combined results of activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, and thyroid stimulating hormone (TSH), performed on outpatients over 15 years of age and referred by general practitioners for routine blood testing. Cumulative results were retrieved for 1,329 such outpatients. Patients with hyperthyroidism had shortened APTT (28.4 vs. 29.4 s; P = 0.043) and higher fibrinogen (4.1 vs. 3.8 g/l; P = 0.028) values when compared with euthyroid patients, whereas no significant differences were observed between euthyroid patients and those with hypothyroidism. Hyperthyroid patients had also an increased prevalence of shortened APTTs (<25.5 s) and higher values of fibrinogen (>4.0 g/l) than those with normal thyroid function. This study confirms that hyperthyroidism might be associated with hypercoagulability due to shortened APTT and increased fibrinogen values. Should these findings be confirmed, consideration should be given to prevent thrombotic complications in patients with hyperthyroidism.

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Section: Discussionmentioning

confidence: 77%

Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients

Lippi

Franchini

Targher

et al. 2008

J Thromb Thrombolysis

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“…Increased levels of fibrinogen, fibrinopeptide A, thrombomodulin, tissue factor pathway inhibitor (TFPI), and factors VIII, IX, von Willebrand factor antigen (vWF Ag), vWF ristocetin co-factor (vWF: RCo), and decreased fibrinolytic activity [increased tissue plasminogen activator inhibitor-1 (PAI-1) and decreased tissue plasminogen activator (t-PA) and plasminogen] in hyperthyroidism have been shown in previous studies [1,[4][5][6][7][11][12][13][14].…”

Section: Introductionmentioning

confidence: 84%

Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor in patients with hyperthyroidism

Erem

Ucuncu

Yılmaz

et al. 2009

Endocr

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Various abnormalities of coagulation-fibrinolytic system have been reported in patients with thyroid dysfunction. Several studies indicate that coagulation and fibrinolytic system is disturbed in the patients with hyperthyroidism. The levels of plasma thrombin-activatable fibrinolysis inhibitor (TAFI) antigen and tissue factor pathway inhibitor (TFPI) have been very rarely investigated in patients with hyperthyroidism. Therefore, the main purpose of this study was to evaluate the profile of coagulation and fibrinolytic parameters including TAFI and TFPI in patients with hyperthyroidism. We also investigated the relationships between serum thyroid hormones and hemostatic parameters in these patients. Thirty patients with untreated hyperthyroidism and 25 age- and sex-matched healthy controls were included in the study. Factor V (FV), protein C, protein S, TFPI, and TAFI were measured. The relationships between serum thyroid hormones and these hemostatic parameters were examined. Compared with the control subjects, TAFI Ag levels were increased significantly in patients with hyperthyroidism [mean ± SD (ranges)] [177.03 ± 20.37 (131-206%) versus 145.9 ± 23.0 (89-169%)] (P < 0.001), whereas FV [89.8 ± 21.02 (49-124%) versus 116.1 ± 31.4 (56.4-200%)], protein C [72.8 ± 46.22 (2-149%) versus 144.0 ± 26.3 (74-158%)] and protein S [60.06 ± 42.82 (9-156%) versus 151 ± 33 (76-231%)] activities and TFPI Ag levels [69.56 ± 17.63 (39-140 ng/ml) versus 87.5 ± 15.9 (64-121 ng/ml)] were decreased significantly (P < 0.001 for all of them). We did not find a significant difference between Graves' disease and toxic nodular goiter for hemostatic parameters. In patients with Graves' disease, serum-free T₃ levels were inversely correlated with TFPI Ag levels (r: -0.57, P < 0.05). In conclusion, we found some important differences in the hemostatic parameters between the patients with hyperthyroidism and healthy controls. Increased TAFI and decreased FV, protein C, protein S, and TFPI in these patients represent a potential hypercoagulable and hypofibrinolytic state, which might augment the risk for atherosclerotic and atherothrombotic complications. Thus, disturbances of the hemostatic system may contribute to the excess mortality due to cardiovascular disease seen in patients with hyperthyroidism.

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“…The incidence of arterial thromboembolism in patients with thyrotoxic atrial fibrillation is higher than in those with nonthyrotoxic atrial fibrillation [5]. Prolonged euglobulin lysis time, reduced fibrinolytic activity, and decreased plasminogen levels in hyperthyroidism have been shown in previous studies [4,6]. The administration of levothyroxine in healthy subjects increases plasma vWF levels, an indicator of endothelial dysfunction and procoagulation [7].…”

mentioning

confidence: 88%

Thrombin Activatable Fibrinolysis Inhibitor Antigen Levels Are Inversely Correlated with Plasminogen Activator Inhibitor-1 Antigen Levels in Hyperthyroid Patients

et al. 2007

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Abstract. Both increased and decreased fibrinolytic activity have been reported in patients with hyperthyroidism. Elevated levels of plasma plasminogen activator inhibitor-1 (PAI-1) antigen have been found in hyperthyroid patients. Thrombin activatable fibrinolysis inhibitor (TAFI) is a novel plasma protein, which inhibits fibrinolysis through removal of C-terminal lysines from partially degraded fibrin. Previously, we showed that plasma TAFI antigen levels were increased in patients with overt and subclinical hypothyroidism. The aim of this study is to investigate plasma levels of TAFI and PAI-1 antigens in hyperthyroid patients. PAI-1 and TAFI antigen levels were measured in the plasma of 29 patients with hyperthyroidism (14 overt hyperthyroid and 15 subclinical hyperthyroid), and 26 healthy individuals. Although there were increased levels of PAI-1 antigen in hyperthyroid patients, plasma TAFI antigen levels were significantly lower compared to controls (80.79 ng/ml vs. 32.42 ng/ml, p = 0.000 for PAI-1; 10.42 µg/ml vs. 12.24 µg/ml, p = 0.009 for TAFI). Elevated PAI-1 antigen levels were positively correlated with free thyroid hormones, although TAFI antigen levels were in negative correlation with free thyroxine. Furthermore, an inverse correlation between PAI-1 and TAFI antigen levels was found. Our study demonstrated that TAFI antigen levels were decreased in patients with hyperthyroidism. Inverse correlation with PAI-1 suggests that the decrease in TAFI antigen levels may be due to activation of TAFI pathway. Further studies evaluating the underlying mechanisms of low TAFI antigen levels in hyperthyroidism should be undertaken.

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Fibrinogen and fibrinolytic activity in hyperthyroidism before and after antithyroid treatment

Cited by 38 publications

References 10 publications

Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients

Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients

Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor in patients with hyperthyroidism

Thrombin Activatable Fibrinolysis Inhibitor Antigen Levels Are Inversely Correlated with Plasminogen Activator Inhibitor-1 Antigen Levels in Hyperthyroid Patients

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