Coagulation and fibrinolysis index profile in patients with ANCA-associated vasculitis

PLoS One. 2014 May 19;9(5):e97843. doi: 10.1371/journal.pone.0097843. eCollection 2014.

Abstract

Background: Previous studies observed the high prevalence of venous thromboembolism in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The current study analyzed the coagulation and fibrinolysis index profile in AAV patients.

Methods: The current study recruited 321 AAV patients in active stage and 78 AAV patients in quiescent stage. Coagulation and fibrinolysis index profiles in these AAV patients were analysed, and their associations with various clinical and pathological parameters were further investigated.

Results: The circulating levels of D-dimer, fibrin degradation products and platelet count were significantly higher in AAV patients in active stage compared with those in remission [0.8 (0.4, 1.5) mg/L vs. 0.28 (0.2, 0.55) mg/L, P<0.05; 5.6 (5.0, 10.0) mg/L vs. 1.9 (1.2, 2.8) mg/L, P<0.05; 269±127×109/L vs. 227±80×109/L, P<0.05, respectively]. Among the 321 AAV patients in active stage, compared with patients with normal levels of D-dimer, patients with elevated D-dimer levels had significantly higher levels of initial serum creatinine, erythrocyte sedimentation rate, C reactive protein and the Birmingham Vasculitis Activity Scores (P = 0.014, P<0.001, P<0.001, P = 0.002, respectively). Moreover, correlation analysis showed that the levels of D-dimer correlated with erythrocyte sedimentation rate and C reactive protein levels (r = 0.384, P<0.001; r = 0.380, P<0.001, respectively).

Conclusion: Patients with active AAV are in hypercoagulable states, and circulating levels of D-dimer are associated with disease activity of AAV.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / physiopathology*
  • Blood Coagulation / physiology*
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Creatine / blood
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Fibrinolysis / physiology*
  • Humans
  • Male
  • Middle Aged
  • Platelet Count

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • C-Reactive Protein
  • Creatine

Grants and funding

This study is supported by a grant of Chinese 973 project (No. 2012CB517702), two grants of the National Natural Science Fund (No. 81370829 and No. 81021004), and “National Key Technology Research and Development (R&D) Program” of the Ministry of Science and Technology of China (No. 2011BAI10B04). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.