Blood coagulation and fibrinolysis in patients with Cushing’s syndrome: Increased plasminogen activator inhibitor-1, decreased tissue factor pathway inhibitor, and unchanged thrombin-activatable fibrinolysis inhibitor levels

2009 ◽  
Vol 32 (2) ◽  
pp. 169-174 ◽  
Author(s):  
C. Erem ◽  
I. Nuhoglu ◽  
M. Yilmaz ◽  
M. Kocak ◽  
A. Demirel ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Plasminogen Activator ◽  
Tissue Factor Pathway Inhibitor ◽  
Plasminogen Activator Inhibitor ◽  
Plasminogen Activator Inhibitor 1 ◽  
Thrombin Activatable Fibrinolysis Inhibitor ◽  
Fibrinolysis Inhibitor ◽  
Tissue Factor Pathway ◽  
Activator Inhibitor ◽  
Coagulation And Fibrinolysis

scholarly journals Increased plasminogen activator inhibitor-1, decreased tissue factor pathway inhibitor, and unchanged thrombin-activatable fibrinolysis inhibitor levels in patients with primary hyperparathyroidism

2009 ◽  
Vol 160 (5) ◽  
pp. 863-868 ◽  
Author(s):  
Cihangir Erem ◽  
Mustafa Kocak ◽  
İrfan Nuhoglu ◽  
Mustafa Yilmaz ◽  
Ozge Ucuncu
Keyword(s):  
Plasminogen Activator ◽  
Tissue Factor Pathway Inhibitor ◽  
Plasminogen Activator Inhibitor ◽  
Plasminogen Activator Inhibitor 1 ◽  
Thrombin Activatable Fibrinolysis Inhibitor ◽  
Tissue Plasminogen ◽  
Fibrinolysis Inhibitor ◽  
Tissue Factor Pathway ◽  
Activator Inhibitor ◽  
Pai 1

Background and objectivesPrimary hyperparathyroidism (PHPT) is associated with increased cardiovascular mortality and morbidity. Little is known about hemostatic features of patients with PHPT. To our knowledge, plasma tissue factor pathway inhibitor (TFPI) and thrombin-activatable fibrinolysis inhibitor (TAFI) levels in these patints have not been investigated. Therefore, the main purpose of this study was to evaluate the markers of endogenous coagulation/fibrinolysis, including TFPI and TAFI, and to investigate the relationships between serum calcium and PTH and these hemostatic parameters in patients with PHPT.Design and methodsTwenty-four patients with PHPT and 20 age-, sex-, and-weight-matched healthy controls were included in the study. Tissue plasminogen activator (t-PA), tissue plasminogen activator inhibitor-1 (PAI-1), TFPI, and TAFI were measured. The relationships between serum calcium, phosphorus, and PTH and these hemostatic parameters were examinated.ResultsCompared with the control subjects, t-PA, PAI-1, and PAI-1/t-PA ratios were significantly increased in patients with PHPT (P<0.0001), whereas TFPI levels were significantly decreased (P<0.0001). Plasma TAFI Ag levels did not significantly change in patients with PHPT compared with the controls. In patients with PHPT, serum phosphorus was negatively correlated with plasma PAI-1 Ag levels and PAI-1/t-PA ratio (r: −0.453,P<0.05;r: −0.580,P<0.01 respectively). There was a positive correlation between Cl/P ratio and plasma PAI-1 levels and PAI-1/t-PA ratio (r: 0.434,P<0.05;r: 0.528,P<0.05 respectively). iPTH was positively correlated with plasma PAI-1/t-PA ratio (r: 0.429,P<0.05).Interpretation and conclusionsIn conclusion, we found some important differences in the hemostatic parameters between the patients with PHPT and healthy controls. Increased PAI-1, PAI-1/t-PA ratios and decreased TFPI levels in these patients represent a potential hypercoagulable and hypofibrinolytic state, which might augment the risk for atherosclerotic and atherothrombotic complications. This condition may contribute to the excess mortality due to cardiovascular disease seen in patients with PHPT.

Imbalance of Plasminogen Activator Inhibitor-I/ Tissue Plasminogen Activator and Tissue Factor/Tissue Factor Pathway Inhibitor in Young Japanese Men with Myocardial Infarction

2001 ◽  
Vol 86 (11) ◽  
pp. 1197-1203 ◽  
Author(s):  
Masahiko Saigo ◽  
Masakazu Ogawa ◽  
Tsuminori Yamashita ◽  
Sadatoshi Biro ◽  
Shinichi Minagoe ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Plasminogen Activator ◽  
Protein C ◽  
Tissue Factor Pathway Inhibitor ◽  
Antithrombin Iii ◽  
Plasminogen Activator Inhibitor ◽  
Lipoprotein A ◽  
Tissue Plasminogen ◽  
Tissue Factor Pathway ◽  
Activator Inhibitor

SummaryTo evaluate the association between haemostatic parameters and increased risk of myocardial infarction (MI) at a young age, we measured fibrinogen, factor VII, antithrombin III, protein C, protein S, tissue factor (TF), free form tissue factor pathway inhibitor (TFPI), plasminogen, 2-antiplasmin, tissue plasminogen activator (tPA), plasminogen activator inhibitor-I (PAI-I), and lipoprotein (a) in 140 young men with MI before age 45 and 150 age-matched healthy men. TF, TF/TFPI ratio, PAI-I, PAI-I/tPA ratio, plasminogen, and lipoprotein (a) in young MI patients were all significantly higher than controls, while TFPI, antithrombin III, and tPA were significantly lower (P <0.001 of each). Significant determinants of MI risk were PAI-I/tPA ratio (R2 = 0.300, P <0.001), TF/TFPI ratio (R2 = 0.049, P <0.001), antithrombin III (R2 = 0.034, P <0.001), hyperlipidaemia (R2 = 0.019, P = 0.004), diabetes (R2 = 0.014, P = 0.015), lipoprotein (a) (R2 = 0.012, P = 0.023), 2-antiplasmin (R2 = 0.014, P = 0.012), and protein C (R2 = 0.012, P = 0.018). We conclude that the imbalances of PAI-I/tPA and TF/TFPI are significantly associated with MI at a young age, perhaps mediated via impaired fibrinolytic activity.

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