Measurement of prethrombotic markers in the assessment of acquired hypercoagulable states

Thromb Res. 1999 Jan 15;93(2):71-8. doi: 10.1016/s0049-3848(98)00165-0.

Abstract

Hypercoagulable states can be detected by measuring activation peptides, enzyme-inhibitor complexes, and fibrin/fibrinogen degradation products, which are markers of hemostatic activation. A series of these prethrombotic markers has been evaluated in the elderly, pregnancy, diabetes and acute myocardial infarction patients (n=30 in each group) as well as in hematologic malignancies (n=42). The parameters assayed were: prothrombin fragment 1+2 (F1+2), thrombin-antithrombin III complexes (TAT), fibrinopeptide A (FPA), plasmin-alpha2 antiplasmin complexes (PAP) and D-Dimer. Results were compared with those obtained in a group of 30 healthy subjects. We found a significant increase of F1+2, TAT and FPA in elderly (p<0.05), acute myocardial infarction (AMI) (p<0.01), hematologic malignancies (p<0.01), and pregnancy (p<0.0001), indicating a marked clotting activation. Diabetic patients under strict metabolic control only presented a moderate increase of TAT (p<0.05), suggesting a slight activation. We also observed a highly significant elevation of PAP and D-Dimer in elderly (p<0.001), AMI (p<0.0001), and malignancy (p<0.0001), indicating an activation of the fibrinolytic system. The combination of selected fibrinolytic and coagulation measurements is useful for the detection of a hypercoagulable state in conditions characterized by a risk of thrombosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Diabetes Complications
  • Evaluation Studies as Topic
  • Female
  • Hematologic Neoplasms / complications
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Hematologic / diagnosis
  • Statistics, Nonparametric
  • Thrombophilia / complications
  • Thrombophilia / diagnosis*

Substances

  • Biomarkers