Differences in fibrinolytic profile between patients with different localizations and types of venous thrombosis

Abstract

Introduction. The role of the fibrinolytic system in venous thrombosis remains incompletely understood. This study aimed to evaluate the effectiveness of the fibrinolytic system in patients with various types and locations of venous thrombosis compared to healthy controls. Material and Methods. The study included 100 patients with venous thrombosis and 100 healthy controls. Patients were stratified based on the type of venous thrombosis (spontaneous vs. provoked) and the location (distal, proximal, and atypical). Global fibrinolytic activity was assessed using euglobulin clot lysis time, while specific fibrinolytic components measured included plasminogen, tissue plasminogen activator, thrombin-activatable fibrinolysis inhibitor, and plasminogen activator inhibitor-1. Results. Patients with isolated distal and provoked venous thrombosis exhibited significantly prolonged euglobulin clot lysis time compared to healthy controls (218.3 ? 41.1 vs. 185.6 ? 42.3 min, p=0.001; 208.2 ? 48.5 min vs. 185.6 ? 42.3 min, p=0.018, respectively). Patients with provoked venous thrombosis demonstrated higher plasminogen (127.1 ? 27.7 vs. 117.1 ? 24.5%, p=0.044) and tissue plasminogen activator levels (20.0 ? 11.1 vs. 16.8 ? 8.1 ng/ml, p=0.042) compared to controls. Thrombin-activatable fibrinolysis inhibitor levels were significantly elevated in patients with both provoked (19.9 ? 4.0 vs. 17.1 ? 4.3 ng/ml, p=0.000) and spontaneous venous thrombosis (19.5 ? 6.0 vs. 17.1 ? 4.3 ng/ml, p=0.02), as well as in cases of isolated distal (20.7 ? 5.0 vs. 17.1 ? 4.3 ng/ml, p=0.001) and proximal (19.4 ? 5.3 vs. 17.1 ? 4.3 ng/ml, p=0.013) venous thrombosis when compared to healthy controls. Conclusion. The study reveals significant variations in the fibrinolytic process across different types and anatomical locations of venous thrombosis compared to healthy individuals.