Short-term Venous Stasis Induces Fibrinolytic Activation but not Thrombin Formation

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概要

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• Aim: Venous stasis is a well-known risk factor for the development of venous thromboembolism. It is likely that stasis increases the risk of thrombosis by inducing hypercoagulability via the hypoxic procoagulant activation of endothelial and mononuclear cells and the accumulation of activated clotting factors. However, increased rates of thrombin formation have not been demonstrated in response to venous stasis in vivo.Methods: In this study, we used the venous occlusion (VO) test to determine, if stasis triggers thrombin formation in healthy individuals (n=25) and patients with additional thrombotic risk factors, such as inherited thrombophilia (n=19) and symptomatic atherosclerosis (n=15). Thrombin formation was monitored by measuring plasma levels of free thrombin using a highly sensitive oligonucleotide enzyme capture assay (OECA) in addition to the plasma levels of prothrombin fragment 1＋2 (F1＋2) and thrombin-antithrombin-complexes (TAT). The plasma levels of activated protein C (APC) were additionally measured using an APC-OECA.Results: VO induced a significant (p＜0.05) increase in the levels of tissue-type plasminogen activator and plasmin-α2-antiplasmin-complexes. In all three cohorts, the majority of samples obtained during VO showed no quantifiable thrombin or APC levels. Consistent with these findings F1＋2 and TAT did not change.Conclusions: We conclude that short-term venous stasis induces a profibrinolytic response due to the activation of endothelial cells, but not a prothrombotic response, even in the presence of additional thrombophilic risk factors. Furthermore, our results support the hypothesis that the stasis-induced profibrinolytic activation of endothelial cells occurs independently from thrombin formation.

• 一般社団法人 日本動脈硬化学会の論文

著者

• Potzsch Bernd

  Institute Of Hemostaseology And Transfusion Medicine Max-planck-institute For Clinical And Physiolog

• Oldenburg Johannes

  Institute For Experimental Haematology And Transfusion Medicine University Clinic Bonn

• Wäschenbach Jana

  Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn

• Rühl Heiko

  Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn

• Müller Jens

  Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn

• Dewald Oliver

  Department of Cardiac Surgery, University Hospital Bonn

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• Short-term Venous Stasis Induces Fibrinolytic Activation but not Thrombin Formation

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