Pre- and Postoperative State of Coagulation and Fibrinolysis in Plasma of Patients with Benign and Malignant Colorectal Disease - A Preliminary Study

Iversen, Lars; Okholm, Mette; Thorlacius‐Ussing, Ole

doi:10.1055/s-0038-1650616

Cited by 52 publications

(50 citation statements)

References 2 publications

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“…The elevated prechemotherapy TAT levels in advanced breast cancer patients in this study support previous findings in breast (Falanga et al, 1998;Donati and Falanga, 2001), lung (Gabazza et al, 1992;Seitz et al, 1997) and colorectal cancer (Iversen et al, 1996;Iversen and Thorlacius-Ussing, 2002).…”

Section: Discussionsupporting

confidence: 91%

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer

et al. 2008

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Venous thromboembolism (VTE) following breast cancer chemotherapy is common. Chemotherapy-induced alterations in markers of haemostasis occur during chemotherapy. It is unclear how rapidly this occurs, whether this is upregulated in patients developing VTE and whether changes predict for VTE. Markers of haemostasis, functional clotting assays and vascular endothelial growth factor were measured before chemotherapy and at 24 h, 4 days, 8 days and 3 months following commencement of chemotherapy in early and advanced breast cancer patients and in age-and sex-matched controls. Duplex ultrasound imaging was performed after 1 month or if symptomatic. Of 123 patients, 9.8% developed VTE within 3 months. Activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer, fibrinogen, platelet count, VEGF and fibrinogen were increased in cancer. Fibrinogen, D-dimer, VEGF and tissue factor were increased, at baseline, in patients subsequently developing VTE. D-dimer of less than 500 ng ml À1 has a negative predictive value of 97%. Activated partial thromboplastin time, PT and thrombin -antithrombin showed significantly different trends, as early as within 24 h, in response to chemotherapy in patients subsequently developing VTE. Markers of coagulation and procoagulants are increased, before chemotherapy, in patients who subsequently develop VTE. A group of patients at minimal risk of VTE can be identified, allowing targeted thrombopropylaxis to the higher risk group.

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Section: Discussionsupporting

confidence: 91%

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer

et al. 2008

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“…As many as 90% of cancer patients will have elevation of plasma-clotting factor levels (fibrinogen, factors V, VIII, IX and XI) and thrombocytosis [10]. In addition, many will have evidence of activation of coag ulation, with elevated levels of D dimer, fibrinopeptide A, F 1.2 and thrombin-antithrom bin complexes [11,12], Decreases in clotting inhibitors have also been reported. Flowever, the frequency of resistance to aPC and its rela tionship to thrombosis in the cancer patient has thus far received little attention.…”

Section: Discussionmentioning

confidence: 99%

Activated-Protein-C Resistance in Cancer Patients

Maliekel¹,

Sushko²,

Akhtar³

et al. 1997

Pathophysiol Haemos Thromb

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Background: Resistance to activated protein C (aPC) is usually linked to factor V Leiden, but may occur in other disorders associated with hypercoagulability. In this study, we investigated the frequency of resistance to aPC in patients with advanced cancer and examined the relationship of aPC resistance to other markers of coagulation activation. Methods: Patients (n = 39) had an established diagnosis of advanced cancer; controls (n = 20) were healthy persons. aPC resistance was measured as the ratio of activated partial thromboplastin times with and without aPC (aPC-sensitivity ratio, aPC-SR). The factor V Leiden mutation was detected by a polymerase-chain-reaction based technique. Other assays were performed by standard laboratory methods. Data were analyzed using t tests and the Pearson correlation. Results: aPC-SR was below 2 SD for 5 of the cancer patients (13%), but none of the controls; only 1 of the 5 had the factor V Leiden mutation. aPC-SR was inversely correlated (p < 0.01) with factor VIII and fibrinogen in patients and with prothrombin activation fragment 1.2 (F1.2) in controls. Patient factor VIII, von Willebrand factor, (vWF), fibrinogen, F1.2 and D dimer were all significantly increased (p < 0.01); antithrombin III, protein C and proteins were similar to controls. Factor VIII correlated with vWF (p < 0.001) and F1.2 with d-dimer (p < 0.001). Other associations (p < 0.05) were observed between factor V and protein C, fibrinogen and protein C, factor V and antithrombin III and protein C and antithrombin III. Four cancer patients had a history of thromboembolism; their aPC-SR was similar to that of patients without thrombosis. Of the several coagulation measures examined, only vWF was higher in the patients with thrombosis (p = 0.01). Interpretation: Cancer patients have evidence of intravascular coagulation and increases in procoagulants and may have aPC resistance. The aPC resistance is not due to factor V Leiden, but is rather associated with elevated levels of factor VIII and fibrinogen, and in itself does not predict thrombosis.

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“…Age 80,88 , diurnal variations 89 , sex and other genetic factors 90 , obesity 91 , medication 92 -95 , ongoing infection 82,94 , smoking and alcohol intake 96 , diabetes 97 , phase of the menstrual cycle 98 , hypercholesterolaemia 99 , benign versus malignant disease 100,101 , stress 90,102 and pregnancy 103 have all been found to influence one or more of the risk factors inflammation, coagulation and fibrinolysis. In addition, numerous surgical factors contribute to fibrin persistence, including type and duration of surgery 77,78,80 , use of irrigation, anaesthetic used 104 , additional medication (such as antibiotics) and blood transfusion 105 .…”

Section: Factors Influencing Inflammation Coagulation Fibrinolysis mentioning

confidence: 99%

Pathogenesis of postoperative adhesion formation

Hellebrekers

Kooistra²

2011

British Journal of Surgery

227

198

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Pre- and Postoperative State of Coagulation and Fibrinolysis in Plasma of Patients with Benign and Malignant Colorectal Disease - A Preliminary Study

Cited by 52 publications

References 2 publications

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer

Activated-Protein-C Resistance in Cancer Patients

Pathogenesis of postoperative adhesion formation

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