Plasminogen activator inhibitor-1, thrombin-antithrombin, and prothrombin fragment F1+2 have higher diagnostic values than D-dimer for venous thromboembolism after TKA

Yang, Yong; Feng, Gangning; Yan, Jiangbo; Wu, Long; Wang, Faxuan; Ding, Dong; Wang, Hui; Jin, Qunhua

doi:10.1177/10760296221097383

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…Frischmuth et al reported that higher plasma PAI-1 levels were associated with an increased risk of future incident VTE [50]. Yang et al suggested that plasma PAI-1 had a higher predictive value for VTE than D-dimer [51]. Thus, our results together with the above reports, may imply that plasma PAI-1 may be a potential biomarker in the diagnosis of VTE.…”

Section: Discussionsupporting

confidence: 74%

Clinical impact of the PAI-1 4G/5G polymorphism in Chinese patients with venous thromboembolism

et al. 2022

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Background Venous thromboembolism (VTE) is a life-threatening cardiovascular syndrome that characterized by the imbalance of hemostasis and thrombosis and the formation of thrombi in the blood vessels. The aim of this study was to elucidate the clinical impact of the PAI-1 4G/5G polymorphism in Chinese patients with VTE. Methods A total of 169 subjects (89 VTE, 10 hyperbilirubinemia, 10 hyperlipidemia and 60 healthy controls) were recruited at Peking Union Medical College Hospital. The accuracy of the TaqMan-MGB RT-PCR method for detecting F5 G1691A (FVL) and PAI-1 4G/5G polymorphisms was evaluated by using sequencing method as the gold standard. Besides, the association of the PAI-1 4G/5G polymorphism with susceptibility, treatment efficacy and recurrence status of VTE in Chinese population were explored. Eventually, the plasma PAI-1 antigen levels and PAI-1 4G/5G polymorphisms were determined on additional 64 subjects (32 VTE and 32 healthy controls) simultaneously. Results The TaqMan-MGB RT-PCR method was proven to be highly accurate in determining the FVL and PAI-1 4G/5G polymorphisms without interference from bilirubin and lipids in the samples. No obvious correlation of the PAI-1 4G/5G polymorphism with VTE was observed in our study by using five genetic models (allele, genotype, dominant, recessive and additive). Additionally, we also observed that individuals with the 4G/5G genotype had lower neutrophil counts and neutrophil-to-lymphocyte ratio (NLR) than the 5G/5G genotype. Furthermore, we found that the patients with the 5G/5G genotype were more likely to achieve complete recanalization compared to the 4G/4G genotype. In addition, individuals carrying the 5G/5G genotype were more likely to develop a recurrence-free status as compared to individuals with the 4G/4G or 4G/5G genotypes. PAI-1 antigen levels in the VTE group were significantly higher than those in the HC group. However, there was no significant difference in the antigen levels of PAI-1 among subjects carrying various genotypes in the VTE group or HC group. Conclusion The PAI-1 4G/5G polymorphism has potential value in assessing the prognosis of Chinese patients with VTE. Our study has laid the foundation for the application of PAI-1 4G/5G polymorphism in the personalized management and monitoring of patients with VTE.

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Section: Discussionsupporting

confidence: 74%

Clinical impact of the PAI-1 4G/5G polymorphism in Chinese patients with venous thromboembolism

et al. 2022

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“…TKA patients are at a heightened risk of venous thromboembolism due to the increased risk of endothelial injury caused by tourniquet use, venous stasis due to leg positioning, and the aberrant activation of the clotting cascade. The incidence of VTE can range from 0.7-53%, depending on the preventive measures taken [11,13]. Whether intermuscular vein thrombosis was classi ed as deep vein thrombosis is one of the main reasons for such a large difference.…”

Section: Discussionmentioning

confidence: 99%

“…However, when samples are obtained before stroke, the power of PAI-1 levels to predict future stroke may be limited [9]. Although the correlation between PAI-1 levels and postoperative VTE after THA and TKA has been reported [10,11], the power of PAI-1 levels to predict future VTE is questionable. People homozygous for the 4G allele have the highest and 5G homozygotes have the lowest PAI-1 levels [12].…”

Section: Introductionmentioning

confidence: 99%

The effect of the plasminogen activator inhibitor-1 4G/5G polymorphism on the Venous thromboembolism risk after total knee arthroplasty

Xu,

Wen

et al. 2023

Preprint

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Background We herein determine the relationship between 4G/5G polymorphism of the plasminogen activator inhibitor-1 (PAI-1) gene and Venous thromboembolism (VTE) after total knee arthroplasty (TKA); and identify independent risk factors associated with deep vein thrombosis (DVT) after TKA through multivariate regression analysis. Methods From August of 2022 to November of 2022, 100 participants who underwent primary knee arthroplasty were enrolled in the study. Venous whole blood samples were collected to determine PAI-1 4G/5G genotypes. Lower extremity venous ultrasound was performed to detect DVT on the 5th day postoperatively or when patients had symptoms of DVT. Univariate analyses were performed using the chi-square test. Variables with a P value of less than 0.10 on univariate analysis were entered into multivariate analysis. reported risk factors (Sex, age, operating time, disease, hemostatic drugs, laterality, D-dimer, anticoagulants) for DVT after knee arthroplasty, although the difference was not significant in our study, were also entered into multivariate analysis. Multivariate analysis was performed using a logistic proportional hazards regression model. Results The incidence of DVT in this study was 52%. There was no significant difference in gender proportion between the DVT group and the non-DVT group. The DVT group had reduced intraoperative blood loss (98.0 ml) than the non-DVT group (134.2 ml), although the difference was not statistically significant. The value of D-dimer in DVT group (0.27) was lower than that in the non-DVT group (0.69), but the difference was not significant. On univariate analysis, the 4G/5G genotype of PAI-1 gene was more represented in DVT group, as compared to the non- DVT group. Sex, age, operating time, disease, hemostatic drugs, laterality, D-dimer, anticoagulants have also been considered predictors of DVT in many studies; therefore, we also included these items in our multivariate analysis. On multivariate analysis, the 4G/5G genotype of PAI-1 gene was identified as independent prognostic factors for DVT after TKA. Conclusions When anticoagulants were used after total knee arthroplasty, the incidence of deep vein thrombosis was 52%. The 4G/5G genotype of PAI-1 gene may be a high-risk factor for DVT in patients undergoing TKA.

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“…However, it has a low positive predictive value and low specificity. More specific markers of venous thromboembolism risk may be listed, i.e., SFMC, TATC, F1 + 2, P- and E-selectin [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about?

Waśkiel‐Burnat

Rakowska

Zaremba

et al. 2023

Dermatol Ther (Heidelb)

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Background Numerous studies have indicated that alopecia areata is associated with a chronic systemic inflammation, which is considered as a risk factor for venous thromboembolism. The aim of the study was to evaluate the following markers of venous thromboembolism risk: soluble fibrin monomer complex (SFMC), thrombin–antithrombin complex (TATC), and prothrombin fragment 1 + 2 (F1 + 2) in patients with alopecia areata and compare them with healthy controls. Methods In total, 51 patients with alopecia areata [35 women and 16 men; mean age: 38 (19–54) years] and 26 controls [18 women and 8 men; mean age: 37 (29–51) years] were enrolled in the study. The serum concentrations of thromboembolism markers were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Results An increased level of SFMC was detected in patients with alopecia areata compared with the controls [25.66 (20–34.86) versus 21.46 (15.38–29.48) µg/ml; p < 0.05)]. In addition, a higher level of F1 + 2 was observed in patients with alopecia areata in comparison with the control group [70150 (43720–86070) versus 38620 (31550–58840) pg/ml; p < 0.001]. No significant correlation was detected among SFMC or F1 + 2 and the Severity of Alopecia Tool (SALT) score, disease duration, or the number of the hair loss episodes. Conclusion Alopecia areata may be associated with an increased risk of venous thromboembolism. Regular screening and preventive management of venous thromboembolism may be beneficial in patients with alopecia areata, especially before and during systemic Janus kinase (JAK) inhibitors or glucocorticoid therapy.

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Plasminogen activator inhibitor-1, thrombin-antithrombin, and prothrombin fragment F1+2 have higher diagnostic values than D-dimer for venous thromboembolism after TKA

Cited by 8 publications

References 21 publications

Clinical impact of the PAI-1 4G/5G polymorphism in Chinese patients with venous thromboembolism

Clinical impact of the PAI-1 4G/5G polymorphism in Chinese patients with venous thromboembolism

The effect of the plasminogen activator inhibitor-1 4G/5G polymorphism on the Venous thromboembolism risk after total knee arthroplasty

Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about?

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