摘要:

Three hundred and forty-three consecutive patients with deep vein thrombosis (DVT) were investigated for the possible presence of occult or undiagnosed cancer, of whom 305 patients had DVT of the lower limbs whereas 38 had DVT of the upper limbs. Cancer was diagnosed during a 12-month follow-up in nine patients with DVT of the upper limbs (23.7%) and in 34 patients with DVT of the lower limbs (11.1%). The difference was statistically significant. Furthermore, it was shown that the majority of cancers (seven of nine) in the case of DVT of the upper limbs were discovered during the first week of hospital admission. In contrast, in the case of DVT of lower limbs, only eight of 34 cancers were discovered during the initial investigation. Lung cancer and lymphomas represented the majority of cancers associated with upper limb venous thrombosis (seven of nine). In the case of DVT of the lower limbs, cancers were heterogeneous; however, 12 of 34 were cancers of the colon or prostate.Blood Coag Fibrinol10:455–457 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The role of blood tests in identifying patients at high risk for post-operative venous thromboembolism is undefined. The aim of this study was to evaluate the correlation between pre-operative plasma levels of soluble fibrin polymers (SFP), as determined by a recently developed enzyme-linked immunosorbent assay (ELISA) assay (TpPTM), and the incidence of deep vein thrombosis (DVT) after elective neurosurgery. Blood samples for SFP assay were withdrawn on the day before surgery from 157 consecutive patients undergoing elective neurosurgery for brain or spinal tumour. Patients were randomized to subcutaneous enoxaparin (40 mg once daily) or placebo given for at least 7 days. All patients wore compression stockings. DVT was assessed by bilateral venography, performed on day 8 ± 1. Thirty-four patients (21.7%) were found to have a DVT, proximal in 11 (7%) and isolated distal in 23. Patients with and without DVT had a plasma pre-operative SFP levels of 6.2 ± 4.6 and 1.9 ± 1.5 mg/ml respectively (mean ± SD) (P< 0.001). SFP levels in patients with proximal and isolated distal DVT were 7.6 ± 5.1 and 5.5 ± 4.4 μg/ml, respectively (P= 0.22). SFP cut-off levels categorized patients into three classes of DVT incidence. The incidence of DVT was 7.4% (6 of 81) for SFP levels < 2 μg/ml, 20.4% (11 of 54) for levels between 2 and 4.5 μg/ml, and 77.3% (17 of 22) for levels > 4.5 μg/ml (P= 0.001, Cochran-Mantel-Haenszel test). We conclude that pre-operative SFP levels correlate with post-operative DVT in elective neurosurgery patients. Further studies are required to define whether pre-operative SFP measurement could be useful in patient management.Blood Coag Fibrinol10:459–463 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Several components of blood, e.g. lipids, coagulation and fibrinolytic factors, are thought to be important risk factors in cardiovascular diseases. The aim of this study was to correlate these risk factors and the soluble adhesion proteins, soluble P-selection (sP-selectin) and soluble vascular cell adhesion molecule (sVCAM-1), in healthy men and women as well as to unravel any effects of smoking. One hundred and forty-two fasting men (median age 36 years) including 39 smokers, and 124 women (median age 34 years) including 35 smokers, were tested between 0800 h and 1000 h. Fibrinogen correlated positively with white blood cells (WBC) (r= 0.25), prothrombin fragment 1.2 (F1.2) (r= 0.21), cholesterol (r= 0.27), β-thromboglobulin (r= 0.29), Factor VII clotting activity (FVIIc) (r= 0.27) (allP< 0.0001), tissue plasminogen activator antigen (t-PAag) (r= 0.22,P< 0.0005), plasminogen activator inhibitor-1 antigen (PAI-lag) (r= 0.20) and VCAM-1 (r= 0.19) (bothP< 0.002). Cholesterol and triacylglycerol (TG) correlated positively with t-PA antigen (t-PAag) (r= 0.36 andr= 0.38), PAI-1 antigen (PAI-lag) (r= 0.35 andr= 0.50), P-selectin (r= 0.26 andr= 0.27) (allP< 0.0001) and WBC (r= 0.17,P< 0.007 andr= 0.18,P< 0.004). Cholesterol correlated also with F1.2 (r= 0.29) and TG (r= 0.44) (P< 0.0001). In addition to cholesterol and TG, sP-selectin correlated postively with PAI-lag (r= 0.39), t-PAag (r= 0.27) and WBC (r= 0.25) (allP< 0.0001). Comparing the various test parameters in men and women, it was found that women had significantly higher levels of F 1.2 and high-density Iipoprotein-cholesterol than men, whereas men had higher levels of t-PAag, PAI-lag and P-selectin than women. Smoking was associated with a rise in several of the test parameters. It can be concluded that there are correlations between several risk factors. Of particular interest is the positive correlation between sP-selectin and a number of established risk factors of cardiovascular diseases.Blood Coag Fibrinol10:465–470 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

An activity detected in a prothrombin complex concentrate, termed ‘thrombin-like’ due to its amidolytic properties, was recently reported by another working group. This serine-protease revealed partial structural homology with a ‘hepatocyte growth factor activator’. An impact of this protease on coagulation has not yet been described. The protease was isolated from plasma fractions by ion exchange chromatography and adsorption to immobilized heparin and/or aprotinin. Clotting tests including the FVIIa-rTF assay were performed employing coagulometry. A monoclonal antibody-derived F(ab‘)2to FVIII was used to investigate the FVIII bypassing activity (FEIBA). The identity of the protease with the so-called ’thrombin-like‘ protease was supported by sequencing of the amino-termini. Its amidolytic activity was significantly enhanced in the presence of calcium and/or heparin. Incubation with purified FVII revealed the generation of FVIIa, but was prevented by pre-incubation of the protease with aprotinin. In contrast, purified FV and FVIII were inactivated. Studying coagulation parameters, clotting times like plasma recalcification times and the prothrombin times were found to be shortened by addition of the protease. Employing a FVIII-inhibitory F(ab’)2 and enhancing clotting times significantly, FEIBA of the protease was found. We demonstrated that the isolated protease activates FVII independent of tissue factor. Net acceleration of coagulation was found in several global clotting assays resulting in anin vitroFEIBA. The physiological relevance of these findings deserves further investigation.Blood Coag Fibrinol10:471–479 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Hypothyroid patients may have several haemostatic abnormalities such as modification of the coagulation proteins and a bleeding tendency. However, conflicting data have been reported, although in some reports, the groups of patients studied were small. We previously reported in a large population that plasma D-dimers and free thyroxine (FT4) levels were inversely correlated. Since D-dimers are also associated with fibrinogen levels, we analysed the relationship between fibrinogen and FT4 levels. The population consisted of 959 patients (61% men and 39% women), 28% of whom were current smokers. We showed that fibrinogen and FT4 levels were inversely correlated (r = −0.12,P =0.0001) in the overall population, in the non-smoker subgroup (r = −0.13,P= 0.0007) and in the subgroup of patients with strictly normal FT4 levels(r= −0.11,P= 0.0006). The relationship between FT4 and fibrinogen levels was independent of age, sex and smoking habits. Furthermore, there was a significant difference between the mean fibrinogen levels in the patients in the lowest FT4 subgroup and those in the highest FT4 subgroup, which was similar to the difference previously observed in patients with or without evidence of atherosclerotic disease in epidemiological studies. In conclusion, we found a negative and independent relationship between fibrinogen and FT4. These results are consistent with our previous findings of a tendency to a more coagulable state in patients with normal-low FT4 levels compared with those with normal-high FT4 levels.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Recently, a chromogenic kit for determination of plasmin inhibitor activity, Coamatic® Plasmin Inhibitor, has been developed with the aim to increase specificity and to allow application to a wide range of automates. The highly sensitive plasmin substrate S-2403 is used and, to further improve specificity, a low level of plasmin and a short incubation time is utilized as well as the incorporation of methylamine to quench α2-macroglobulin activity. The Coamatic® Plasmin Inhibitor kit has been evaluated regarding specificity and compared with six commercially available plasmin inhibitor (also denoted α2-antiplasmin) kits and with the manual Immediate Plasmin Inhibition Test (IPIT) method, the reference method within the framework of the European Concerted Action against Thrombosis and Disabilities. Analysis of plasmin inhibitor deficient plasma with Coamatic® Plasmin Inhibitor resulted in activities below 5% for all instrument applications, whereas all other commercial kits displayed unexpectedly higher values for this plasma (16–35%). There was a good agreement between the Coamatic® Plasmin Inhibitor method and the IPIT method for all tested instrument applications; slope = 0.80–1.02 and r = 0.92–0.97. No interference was detected from α2-macrogIobulin, lysine, unfractionated and low-molecular weight heparin, and c-amino caproic acid or from the non-plasminogen binding form of plasmin inhibitor.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In anin vitrostudy, anticoagulant and antiplatelet effects of the synthetic, direct factor Xa inhibitor DX-9065a, (+)-2S-2-[4-[[(3S)-1-acetimidoyl-3-pyrrolidinyl]oxy]phenyl]-3-[7-amidino-2-naphthyl]propanoic acid hydrochloride pentahydrate, which shows a high affinity and selectivity towards the enzyme, were investigated. Anticoagulant actions of DX-9065a were studied in human plasma using global clotting assays [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and Heptest®]. The effect on thrombin generation was measured in whole blood by determining the plasma concentration of prothrombin fragment F1.2. The influence on agonist-induced platelet activation in whole blood was studied using flow cytometric analysis. DX-9065a caused a concentration-dependent prolongation of clotting times in the PT and APTT assay, whereas Heptest® was less affected and TT was not influenced. Furthermore, DX-9065a strongly inhibited the generation of thrombin without and after coagulation activation. The factor Xa inhibitor did not affect platelet activation mediated by either thrombin receptor activating peptide, arachidonic acid or y-thrombin, but prevented tissue factor- and factor Xa-induced activation of platelets in a concentration-dependent manner. Inactivation of factor Xa by a highly effective and selective inhibitor, and the resulting inhibition of thrombin generation leads to strong anticoagulant and antiplatelet actions. The interference with the coagulation system at the early level of factor Xa is expected to be an effective approach for a successful anticoagulant/antithrombotic therapy.Blood Coag Fibrinol10:495–501 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We investigated antithrombin III (ATHI)-dependency of the anticoagulant effects of human urinary soluble thrombomodulin (UTM) bothin vivoandin vitro,in comparison with those of heparins. For neutralization of rat plasma ATIII activity, we used F(ab‘)2fragment of anti-rat ATIII antibody and could establish an appropriatein vivomodel to evaluate the ATIII-dependency of antithrombotic agents. The efficacy of UTM on thromboplastin-induced disseminated intravascular coagulation produced in ATIII-decreased rats was almost the same as that in normal rats, whereas unfractionated (UF)-heparin remarkably diminished its effect in ATIII-decreased rats. The prolongation effect of UTM on activated partial thromboplastin time or prothrombin time in plasmain vitrowas unchanged in both normal and ATIII-decreased rats, but the effect of UF-heparin remarkably diminished in ATIII-decreased rat plasma. Such ATIII-independence in the anticoagulant effect of UTM was also observed in human plasma. Thus, differing from heparins, since the anticoagulant effect of UTM does not depend on plasma ATIII activity, UTM is expected to be a useful antithrombotic agent for the treatment of thromboembolic diseases, even in the case with low plasma ATIII activity.Blood Coag Fibrinol10:503–511 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Inhibitory effects of sarpogrelate hydrochloride (sarpogrelate), a 5-HT2receptor antagonist, on platelet aggregation was examined as well as the relationship to serotonin and P-selectin, a platelet alpha-granule membrane glycoprotein. Platelet aggregation was induced by simultaneous addition of collagen (0.06–0.12 μg/ml), which did not induce aggregation alone, and serotonin (0.88 μmol/l) to platelet-rich plasma (PRP). The PRP was obtained from healthy volunteers and percentage maximum aggregation (MA) was measured. Serotonin levels and P-selectin levels in the supernatant of PRP after aggregation were determined. When vehicle-treated PRP was stimulated in the aforementioned manner, platelet aggregation dependent on collagen concentration was induced. Serotonin levels and P-selectin levels were also dependent on collagen concentration. Sarpogrelate (10-6to 10-4mol/1) inhibited such aggregation dose-dependently, and decreased serotonin levels and P-selectin levels in a dose-dependent manner. There were close correlations between MA and serotonin levels, MA and P-selectin levels, as well as serotonin and P-selectin levels. These results suggest that extracellular release of serotonin and P-selectin from platelets was caused by induction of aggregation, and these responses were suppressed by sarpogrelate.Blood Coag Fibrinol10:513–519 © 1999 Lippincott Williams & Wilkins.

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0957-5235    

出版商:OVID    

年代:1999

数据来源: OVID