HYPERHOMOCYSTEINEMIA AS A FACTOR OF FIBRINOLYSIS DISTURBANCES IN PATIENTS WITH ACTIVATED INTRAVASCULAR COAGULATION
https://doi.org/10.18705/1607-419X-2013-19-5-435-441
Abstract
Background. High blood concentration of D-dimer is a reliable marker of activation of intravascular coagulation, but does not provide unambiguous information about the functional potential of the ibrinolytic system.
Objective. To determine the contribution of hyperhomocysteinemia (HHcy) in ibrinolysis disturbances in patients with activated intravascular coagulation.
Design and methods. Plasma samples of 141 patients with activated intravascular coagulation of various etiologies [82 women (58,2 %) and 59 men (41,8 %), mean age 53,2 ± 7,8 years] with the level of D-dimer > 500 ng/ml were studied. The level of total Hcy (tHcy) was determined by high-performance liquid chromatography. In 57 samples ibrinolytic capacity was investigated by turbidimetric global coagulation and ibrinolysis test using as inducers thrombin and tissue plasminogen activator, respectively. 20 samples of donors matched for age and sex served as a comparison group.
Results. In 52 patients (36,9 % of the total sample) tHcy level was greater than 12 µM, thus a modest HHcy was observed. In 29 patients (50,9 % of the patients tested for ibrinolysis capacity) the activation of intravascular coagulation was combined with hypoibrinolysis, and the frequency of HHcy in this group reached 58,6 %. A strong correlation between the time of ibrinolysis and tHcy concentration was found (Rs = 0,564, p = 0,0001).
Conclusion. Thus, it appears that moderate HHcy is not only one of the risk factors for the activation of intravascular coagulation, but also causes inhibition of ibrinolysis in this pathology.
About the Authors
T. F. Subbotina
The First Pavlov St Petersburg State Medical University, St Petersburg;
Federal Almazov Medical Research Centre, St Petersburg, Russia
Russian Federation
Corresponding author: Тhe First Pavlov St Petersburg State Medical University, 6–8 L. Tolstoy, St Petersburg, Russia, 197022. Е-mail: subbotina2002@ mail.ru (Tatiana F. Subbotina, MD, PhD, Professor, the Head of the Laboratory of Biochemical Monitoring at the Biochemical Department of the Research Centre of the First Pavlov St Petersburg State Medical University).
Russian Federation
Corresponding author: Тhe First Pavlov St Petersburg State Medical University, 6–8 L. Tolstoy, St Petersburg, Russia, 197022. Е-mail: subbotina2002@ mail.ru (Tatiana F. Subbotina, MD, PhD, Professor, the Head of the Laboratory of Biochemical Monitoring at the Biochemical Department of the Research Centre of the First Pavlov St Petersburg State Medical University).
A. F. Zhloba
The First Pavlov St Petersburg State Medical University, St Petersburg;
Federal Almazov Medical Research Centre, St Petersburg, Russia
Russian Federation
Russian Federation
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Review
For citations:
Subbotina T.F., Zhloba A.F. HYPERHOMOCYSTEINEMIA AS A FACTOR OF FIBRINOLYSIS DISTURBANCES IN PATIENTS WITH ACTIVATED INTRAVASCULAR COAGULATION. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2013;19(5):435-441. (In Russ.) https://doi.org/10.18705/1607-419X-2013-19-5-435-441
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