PMID- 23963720
OWN - NLM
STAT- MEDLINE
DCOM- 20150212
LR  - 20211021
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 38
IP  - 1
DP  - 2014 Jul
TI  - Hyperhomocysteinemia in patients with pulmonary embolism is associated with 
      impaired plasma fibrinolytic capacity.
PG  - 45-9
LID - 10.1007/s11239-013-0981-1 [doi]
AB  - Hyperhomocysteinemia (HHcy) affects haemostasis and shifts its balance in favour 
      of thrombosis. In vitro and in vivo studies suggested that HHcy may impair 
      fibrinolysis either by influencing the plasma levels of fibrinolytic factors or 
      by altering the fibrinogen structure. We investigated the influence of mild HHcy 
      levels on plasma fibrinolytic potential by using clot lysis time (CLT) and fibrin 
      susceptibility to plasmin-induced lysis in 94 patients with previous pulmonary 
      embolism and no pulmonary hypertension. CLT was measured as lysis time of tissue 
      factor induced clots exposed to exogenous tissue plasminogen activator (t-PA). 
      The rate of in vitro plasmin-mediated cleavage of fibrin beta-chain was assessed 
      over a 6-h period on fibrin clots, which were obtained by exposition to thrombin 
      of purified fibrinogen. Homocysteine plasma levels were measured by Abbott Imx 
      immunoassay and we considered as altered the values above 15 mumol/L according to 
      the literature. In 68 patients homocysteine levels were below 15 mumol/L (NHcy) 
      and in 26 they were above (HHcy). Significant differences were observed between 
      the two groups regarding plasma fibrinolytic potential (p = 0.016), TAFIact 
      (expressed as clot lysis ratio) (p = 0.02), t-PA (0.008) and PLG (0.037), but not 
      for the other assessed components. The HHcy-patients had a threefold higher risk 
      to have an impaired fibrinolysis. Instead, a multivariate logistic regression 
      analysis adjusted for significances of univariate showed that HHcy (OR 5.2 95% CI 
      1.7-15.9; p = 0.003) and BMI (OR 5.0 95% CI 1.6-15.9; p = 0.006) resulted 
      independently associated with impaired fibrinolytic activity. HHcy affects 
      TAFI-mediated hypofibrinolysis but not fibrin(ogen) structure or function as 
      documented by fibrin degradation analysis.
FAU - Cellai, Anna Paola
AU  - Cellai AP
AD  - Department of Heart and Vessels, Thrombosis Centre, Azienda 
      Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy, 
      annapaolacellai@tiscali.it.
FAU - Lami, Donatella
AU  - Lami D
FAU - Antonucci, Emilia
AU  - Antonucci E
FAU - Liotta, Agatina Alessandrello
AU  - Liotta AA
FAU - Rogolino, Angela
AU  - Rogolino A
FAU - Fedi, Sandra
AU  - Fedi S
FAU - Fiorillo, Claudia
AU  - Fiorillo C
FAU - Becatti, Matteo
AU  - Becatti M
FAU - Cenci, Caterina
AU  - Cenci C
FAU - Marcucci, Rossella
AU  - Marcucci R
FAU - Abbate, Rosanna
AU  - Abbate R
FAU - Prisco, Domenico
AU  - Prisco D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 9001-31-4 (Fibrin)
RN  - EC 3.4.21.7 (Fibrinolysin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Fibrin/*metabolism
MH  - Fibrinolysin/*metabolism
MH  - *Fibrinolysis
MH  - Humans
MH  - *Hyperhomocysteinemia/blood/complications
MH  - Male
MH  - Middle Aged
MH  - *Proteolysis
MH  - *Pulmonary Embolism/blood/complications
MH  - Risk Factors
EDAT- 2013/08/22 06:00
MHDA- 2015/02/13 06:00
CRDT- 2013/08/22 06:00
PHST- 2013/08/22 06:00 [entrez]
PHST- 2013/08/22 06:00 [pubmed]
PHST- 2015/02/13 06:00 [medline]
AID - 10.1007/s11239-013-0981-1 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2014 Jul;38(1):45-9. doi: 10.1007/s11239-013-0981-1.