Changes in Biomarkers of Coagulation Fibrinolytic and EndothelialFunctions for Evaluating the Predisposition to Venous Thromboembolism inPatients With Hereditary Thrombophilia

摘要

The changes in the coagulation, fibrinolytic, and endothelial functions arecorrelated with the pathophysiology of the thromboembolic diseases during acuteillness. However, these changes in patients with hereditary thrombophilia whowere not in the acute stage of venous thromboembolism (VTE) are unclear. A panelof 4 biomarkers, including thrombin–antithrombin complex (TAT),plasmin-α2-plasmin inhibitor complex (PIC), tissue-type plasminogenactivator/plasminogen activator inhibitor-1 complex (t-PAIC), and solublethrombomodulin (sTM), were assayed in 100 healthy controls and 100 patients withthrombophilia. Although significantly higher concentrations of TAT, PIC, t-PAIC,and sTM were observed in patients with thrombophilia than in healthy controls,70 patients showed absolutely normal levels of the above 4 biomarkers. Among theother 30 patients who had at least 1 biomarker out of the correspondingreference interval, 26 of them presented elevated PIC with or without increasedTAT. Except for sTM, other 3 biomarkers did not show significant differences inpatients with previous VTE compared to those without. Patients with singleepisode of VTE had obviously lower t-PAIC than those with multiple episodes ofVTE, whereas the levels of TAT, PIC, and sTM were unassociated with the numberof thrombosis episodes. Most thrombophilia patients who were not in the acutestage of VTE showed normal coagulation, fibrinolytic, and endothelial functions.Thus, we were unable to show that the one-time response of this panel wasclinically helpful in determining thrombosis risk in thrombophilia individuals.Future studies should focus on the dynamic monitoring during the chronic phaseof VTE to offer special advantages for patients with thrombophilia.