Selected Haemostatic Factors in Carotid Bifurcation Plaques of Patients Undergoing Carotid Endarterectomy

Migdalski, Arkadiusz; Jawień, Arkadiusz; Kotschy, M; Knapik-Bieniek, A

doi:10.1016/j.ejvs.2003.11.001

Cited by 5 publications

(12 citation statements)

References 34 publications

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“…We did not simultaneously measure thrombin generation potential and Thrombin Antithrombin (TAT) complexes in this study. However, if one considers our findings in conjunction with those of Migdalski et al ,22 our data suggest that measurement of ‘overall thrombin generation potential’ in plasma appears to be a more sensitive and comprehensive indicator of enhanced coagulation system activation/potential than measurement of TAT complexes alone. We did not perform simultaneous histological or biochemical carotid plaque analyses in our study, so we cannot comment on the relationship between thrombin generation parameters and histologically defined plaque morphology.…”

Section: Discussionsupporting

confidence: 71%

Increased thrombin generation potential in symptomatic versus asymptomatic moderate or severe carotid stenosis and relationship with cerebral microemboli

Kinsella

Tobin

Kavanagh

et al. 2014

J Neurol Neurosurg Psychiatry

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Background and purpose: von Willebrand factor propeptide (VWF:Ag II) is potentially a more sensitive marker of acute endothelial activation than von Willebrand factor antigen (VWF:Ag). These biomarkers have not been simultaneously assessed in asymptomatic versus symptomatic carotid stenosis patients. The relationship between endothelial activation and cerebral microembolic signals (MESs) detected on transcranial Doppler ultrasound is unknown. Methods: In this multicentre observational analytical study, plasma VWF:Ag and VWF:Ag II levels in patients with ≥50% asymptomatic carotid stenosis were compared with those from patients with ≥50% symptomatic carotid stenosis in the 'early' (≤4 weeks) and 'late' (≥3 months) phases after transient ischaemic attack or ischaemic stroke. Endothelial activation was also longitudinally assessed in symptomatic patients during follow-up. Transcranial Doppler ultrasound monitoring classified patients as MES-positive or MES-negative. Results: Data from 31 asymptomatic patients were compared with those from 46 early symptomatic and 35 late phase symptomatic carotid stenosis patients, 23 of whom had undergone carotid intervention. VWF:Ag II levels were higher in early (12.8 lg/ml; P < 0.001), late (10.6 lg/ml; P = 0.01) and late post-intervention (10.6 lg/ml; P = 0.038) symptomatic patients than asymptomatic patients (8.9 lg/ml). VWF:Ag levels decreased in symptomatic patients followed up from the early to late phase after symptom onset (P = 0.048). Early symptomatic MES-negative patients had higher VWF: Ag II levels (13.3 vs. 9.0 lg/ml; P < 0.001) than asymptomatic MES-negative patients. Conclusions: Endothelial activation is enhanced in symptomatic versus asymptomatic carotid stenosis patients, in early symptomatic versus asymptomatic MES-negative patients, and decreases over time in symptomatic patients. VWF:Ag II levels are a more sensitive marker of endothelial activation than VWF:Ag levels in carotid stenosis. The potential value of endothelial biomarkers and concurrent cerebral MES detection at predicting stroke risk in carotid stenosis warrants further study.

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Section: Discussionsupporting

confidence: 71%

Increased thrombin generation potential in symptomatic versus asymptomatic moderate or severe carotid stenosis and relationship with cerebral microemboli

Kinsella

Tobin

Kavanagh

et al. 2014

J Neurol Neurosurg Psychiatry

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“…Previousstudieshaveshown an increase in plasma thrombin generation in vivo in the presenceofCAD and CVE (8)(9)(10)25). Thus, the presenceofCAD and CVEwere potentialconfounders in our study.Inour study,personswith carotid stenosis hadsignificantly higher frequencyofCAD and CVEcompared to controls, butnodifferences were observedbetween the twoplaque groups.…”

Section: Discussionmentioning

confidence: 60%

“…In addition, thrombin generation increased linearly withplaque echogenicity and multiple regression analysis revealed echogenicity as an independent predictor forTAT,F1+2and FV. In addition to higher thrombogenicity and susceptibilityo f echolucent atherosclerotic plaques, histopathological studiesof carotid plaqueso btained after endarterectomyi ns ymptomatic patients arer eported to contain moreT AT,i ntraplaque fibrin, foamc elli nfiltration and to have at hinner fibrous capt han in asymptomatic patients (10,26). Hence,weexpected that persons with echolucent carotid plaqueswould have increased thrombin generation in plasma.I nc ontrast, we experienced increased thrombin generation in persons with echogenic carotid plaques independent of traditional atherosclerotic risk factors, regular use of drugs and degree of stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, circulating levels of F1+2and TATare specific molecular markers of thrombin generation. Plasma levels of TATand F1+2 areincreased in coronary and carotid atherosclerosis, butnot related to the severity of the disease (8)(9)(10). Elevatedplasma levels of TATand F1+2 arealso reported in acutem yocardialinfarction and stroke (11,12) and shown to be independent predictors for newevents and mortality (12,13).…”

Section: Introductionmentioning

confidence: 99%

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Increased thrombin generation in persons with echogenic carotid plaques

Mathiesen¹,

Østerud²,

Amiral³

et al. 2008

Thromb Haemost

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Echolucent carotid plaques are associated with higher risk for future ischemic cerebrovascular events (CVE) than echogenic plaques independent of the degree of stenosis. Elevated markers of thrombin generation are associated with atherosclerotic plaques and are increased in the acute and chronic phases of CVE. The present study was conducted to investigate the influence of plaque morphology on thrombin generation in persons with carotid stenosis. One hundred twenty-eight persons with carotid stenosis (>or=35% lumen diameter reduction) and 136 matched controls without stenosis were recruited from the health survey of the Tromsø Study. Blood samples were collected and plaque morphology determined by ultrasonography. Thrombin generation was assessed by thrombin-antithrombin complexes (TAT) and by prothrombin fragment 1+2 (F1+2). Persons with echogenic plaques (n = 63) had significantly higher levels of TAT (5.24 microg/l, 4.33-6.14) (mean, 95%CI) than persons with echolucent plaques (n = 65) (3.44 microg/l, 2.91-3.96, p < 0.001) and controls (n = 136) (3.33 microg/l, 3.06-3.60, p < 0.001). They also had significantly higher levels of F1+2 (2.14 nM, 1.83-2.45) than persons with echolucent plaques (1.54 nM, 1.38-1.71, p < 0.001) and controls (1.49 nM, 1.40-1.58, p < 0.001). TAT and F1+2 increased linearly with plaque echogenicity (p = 0.002 and p = 0.001, respectively) independent of the degree of stenosis. Increased thrombin generation was associated with a significant increase in plasma factor V levels among persons with echogenic plaques compared to echolucent plaques (p = 0.049) and controls (p = 0.025). The present findings indicate that increasing plaque echogenicity, rather than plaque echolucency and the degree of stenosis, is associated with thrombin generation in persons with carotid stenosis.

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“…PAD patients exhibit a prothrombotic or thrombogenic state of blood and thromboembolic complications. These plasma clotting and fibrinolytic parameters together with tissue factor (TF) and tissue factor pathway inhibitor (TFPI) can be found in the structure of atherosclerotic plaques [4,5]. TF is the principal initiator of the extrinsic blood coagulation pathway and the major factor inducing fibrin deposition in vivo.…”

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confidence: 99%

Tissue Factor and Other Hemostatic Parameters in Patients with Advanced Peripheral Artery Disease After Endovascular Revascularization – Search for Hemostatic Factors which Indicate Restenosis

Kotschy

Socha

et al. 2015

Adv Clin Exp Med

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Background. In patients with peripheral artery disease (PAD) a hypercoagulable state and thromboembolic complications occur. Revascularization procedures increase this state, sometimes leading to restenosis. Restenosis following balloon angioplasty (PTA)and stent implantation is ≥ 50% of artery stenosis. Objectives. To determine the concentration of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-antithrombin (TAT) complexes, fibrinogen and D-dimers in the blood of patients with PAD after peripheral endovascular revascularization of the lower legs and in PAD patients with restenosis. Material and Methods. The study included 150 patients with PAD, 90 men and 60 women, aged 44-88 (mean 65.5) years, after successful peripheral angioplasty (PTA) and/or with stenting. During the 6 months after the revascularization procedures, restenosis occurred in 27 patients. The reference group consisted of 53 healthy persons (44 men and 9 women, aged 20-56 years). Blood was drawn in the morning into 3.2% natrium citrate at a ratio of 9 : 1. The concentration of TF, TFPI, TAT complexes and D-dimers were measured in plasma with commercial tests using an enzyme immunoassay. Fibrinogen was determined with coagulometer. Results. In the plasma of patients with PAD after endovascular revascularization, the concentrations of TF, TAT complexes, fibrinogen and D-dimers were significantly higher compared to the reference group. During the six months of observation, 27 patients developed restenosis. The results of hemostatic factors in patients with restenosis were compared with the same patients before restenosis and the group of 123 PAD patients after endovascular revascularization. TF and fibrinogen levels in the 27 patients with restenosis were significantly higher than in the group of PAD patients before restenosis. Conclusions. Statistically significantly higher levels of tissue factor (TF) and fibrinogen in PAD patients with new restenosis, compared to those without restenosis after endovascular revascularization, indicate they can participate in the formation of restenosis (Adv Clin Exp Med 2015, 24, 1, 93-98).

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Selected Haemostatic Factors in Carotid Bifurcation Plaques of Patients Undergoing Carotid Endarterectomy

Cited by 5 publications

References 34 publications

Increased thrombin generation potential in symptomatic versus asymptomatic moderate or severe carotid stenosis and relationship with cerebral microemboli

Increased thrombin generation potential in symptomatic versus asymptomatic moderate or severe carotid stenosis and relationship with cerebral microemboli

Increased thrombin generation in persons with echogenic carotid plaques

Tissue Factor and Other Hemostatic Parameters in Patients with Advanced Peripheral Artery Disease After Endovascular Revascularization – Search for Hemostatic Factors which Indicate Restenosis

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