Abnormal plasma fibrinolysis in patients with rheumatoid arthritis and impaired endothelial fibrinolytic response in those complicated by vasculitis.

Abstract

Objectives-(a) To assess plasma fibrinolytic parameters in patients with rheumatoid arthritis (RA) and to determine whether there are differences between patients with RA alone and those with RA complicated by vasculitis. (b) To determine if patients with RA respond differently to venous occlusion compared with normal subjects and to assess whether such a response differs in patients with RA alone and those with rheumatoid vasculitis. (c) To determine the extent of vascular damage in patients with rheumatoid vasculitis and if this correlates with the levels of plasma fibrinolytic parameters.

Plasma indices of endothelial and platelet activation in Rheumatoid Disease: Relationship to cardiovascular co-morbidity

“…These findings are consistent with previous data, especially among those with vasculitis [11,12], perhaps reflecting increased release due to direct endothelial injury. Recently, a link between vWF and ultrasonographic carotid intima thickness (IMT, an indirect marker of coronary disease) in RD was reported [13], although a previous study reported no such correlation in 39 patients with established RD [14].…”

Rheumatoid disease and ischaemic heart disease: Insights from pathophysiology and vascular biology

“…Of the fibrinolytic factors assayed, increased tissue plasminogen activator (tPA) was noted in one study [8], but not in another [16]. Similar findings have been observed with plasminogen activator inhibitor (PAI) [8,16,78]. Levels of PAI and tPA independently predicted cardiac events in 74 seropositive patients [41].…”

The Major Synovial Targets of the Rheumatoid Arthritis-Specific Antifilaggrin Autoantibodies Are Deiminated Forms of the α- and β-Chains of Fibrin

“…In the RA joints, accumulation of fibrin is thought to result from an altered balance between coagulation and fibrinolysis. It could contribute to chronicity and progressivity of the disease through the proinflammatory and degradative effects of various factors participating in and resulting from its formation and elimination (31)(32)(33)(34)(35)(36). A more disease-specific role for fibrin in the pathogenesis of RA is very probably through its action as an autoantigen and perhaps as an immunogen.…”