Prothrombotic fibrin clot properties are associated with post-discharge venous thromboembolism in acutely ill medical patients

Fibrin-Platelet Clots in Acute Ischemic Stroke. Predictors and Clinical Significance in a Mechanical Thrombectomy Series

“…We also detected a significant association between levels of CRP after EVT and the presence of FPC. Other studies looking at coronary artery disease (19) and deep venous thrombosis (20) have shown that CRP-level increases were associated with FPC formation. A study performed in patients with acute coronary syndrome (21) has shown a strong association between CRP levels and resistance to FPC lysis, so acute-phase reactants could act as platelet aggregation and clot hardness markers.…”

Unfavorably altered fibrin clot properties are associated with recurrent venous thromboembolism in medical patients following post-discharge events

“…The design of the study has been published previously [5]. In the current report we assessed 2 age-and sex-matched groups of 48 adult patients who suffered from VTE within 4 weeks since discharge from internal medicine wards.…”

“…cancer, or end-stage kidney disease, and current anticoagulation. We compared follow-up data of the failed thromboprophylaxis group (acutely ill medical patients who developed postdischarge VTE despite thromboprophylaxis with low-molecular-weight heparins during the index hospital stay) and no thromboprophylaxis group (acutely ill medical patients without such thromboprophylaxis who suffered from VTE within 4 weeks after discharge) reported previously [5]. Causes of the index hospitalization included: exacerbation of asthma or chronic obstructive pulmonary disease (COPD), pneumonia, exacerbation of chronic heart failure, relapse of rheumatic diseases (systemic lupus erythematosus, rheumatoid arthritis, and other).…”

“…There is uncertainty of risk factors for recurrence of VTE among acutely ill medical patients who have experienced VTE following discharge from hospital. In 2019 Wójcik et al [5] reported that characteristics of fibrin clots such as clot lysis time (CLT), maximum rate of increase in D-dimer levels during clot degradation (D-Drate), clot permeability, and lag phase of fibrin formation are unfavorably altered in patients with post-discharge VTE despite pharmacological thromboprophylaxis and their clot phenotype is similar to that observed in patients following unprovoked VTE. Prothrombotic plasma fibrin clot phenotype conditioned by both genetic and environmental factors has been demonstrated to increase the risk of recurrent DVT and PE [6,7].…”

Fibrinolysis in Venous Thromboembolism

“…Compared with individuals without history of VTE, patients following VTE within the first month after hospital discharge despite use of prophylactic doses of low-molecular-weight heparin during hospital stay formed denser fibrin networks which were lysed at a lower rate, and prolonged CLT showed association with elevated C-reactive protein, thrombin generation, and α 2 -antiplasmin. 88 Failed thromboprophylaxis in hospitalized trauma patients was associated with 45% longer CLT largely driven by elevated α 2 -antiplasmin compared with controls with effective thromboprophylaxis. 89…”