PMID- 24128780
OWN - NLM
STAT- MEDLINE
DCOM- 20140812
LR  - 20180823
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 40
IP  - 12
DP  - 2013 Dec
TI  - Patients with antineutrophil cytoplasmic antibodies associated vasculitis in 
      remission are hypercoagulable.
PG  - 2042-6
LID - 10.3899/jrheum.130200 [doi]
AB  - OBJECTIVES: The risk of venous thromboembolism (VTE) is increased in patients 
      with antineutrophil cytoplasmic antibodies (ANCA) associated vasculitides (AAV) 
      as compared to healthy subjects. The mechanisms underlying this increased 
      occurrence of VTE are not completely understood. We hypothesize that AAV patients 
      in remission are more procoagulant than healthy controls. METHODS: Patients with 
      AAV in remission and no VTE for the last 6 months were included. Patients with 
      severe renal impairment (serum creatinine > 250 mumol/l) were excluded. Age and 
      sex matched healthy controls were included. The endogenous thrombin potential 
      (ETP) was determined together with hemostatic variables: fibrinogen, D-dimers, 
      factor VIII (FVIII), tissue factor pathway inhibitor (TFPI), protein C, and free 
      protein S. RESULTS: Thirty-one patients were included. In 27 patients not taking 
      anticoagulants, ETP was measured and found to be elevated: 137.1% as compared to 
      a median of 90.0% for healthy controls (p < 0.01). Fibrinogen and D-dimer levels 
      were not elevated in patients (median 3.5 g/l and 279 mug/l, respectively). FVIII 
      and TFPI levels were also significantly increased in patients as compared to 
      healthy controls (159% vs 137%; 122.5% vs 101%, respectively), whereas protein C 
      and free protein S levels were not elevated (126.5% vs 118.6% and 124.6% vs 
      118.3%, respectively). CONCLUSION: Patients with AAV in remission are more 
      procoagulant than healthy controls, as indicated by an increased ETP. The 
      increased FVIII level measured in these patients suggests persistence of 
      endothelial activation and/or dysfunction. This endothelial dysfunction may cause 
      a continuous low-grade procoagulant state.
FAU - Hilhorst, Marc
AU  - Hilhorst M
AD  - From the Department of Internal Medicine/Division of Clinical and Experimental 
      Immunology; Department of Internal Medicine/Laboratory for Clinical Thrombosis 
      and Hemostasis, Cardiovascular Research Institute Maastricht, Maastrich 
      University Medical Center; and Department of Biochemistry; Maastricht University 
      Medical Center, Maastricht, The Netherlands.
FAU - Winckers, Kristien
AU  - Winckers K
FAU - Wilde, Benjamin
AU  - Wilde B
FAU - van Oerle, Rene
AU  - van Oerle R
FAU - ten Cate, Hugo
AU  - ten Cate H
FAU - Tervaert, Jan Willem Cohen
AU  - Tervaert JW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131015
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 0 (Lipoproteins)
RN  - 0 (Protein C)
RN  - 0 (Protein S)
RN  - 0 (fibrin fragment D)
RN  - 0 (lipoprotein-associated coagulation inhibitor)
RN  - 839MOZ74GK (F8 protein, human)
RN  - 9001-27-8 (Factor VIII)
RN  - 9001-32-5 (Fibrinogen)
RN  - EC 3.4.21.5 (Thrombin)
SB  - IM
CIN - J Rheumatol. 2013 Dec;40(12):1935-7. PMID: 24293615
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/blood/epidemiology/*immunology
MH  - Antibodies, Antineutrophil Cytoplasmic/blood/*immunology
MH  - Factor VIII/immunology/metabolism
MH  - Female
MH  - Fibrin Fibrinogen Degradation Products/immunology/metabolism
MH  - Fibrinogen/immunology/metabolism
MH  - Follow-Up Studies
MH  - Humans
MH  - Lipoproteins/immunology/metabolism
MH  - Male
MH  - Middle Aged
MH  - Protein C/immunology/metabolism
MH  - Protein S/immunology/metabolism
MH  - Remission Induction
MH  - Risk Factors
MH  - Thrombin/immunology/metabolism
MH  - Thrombophilia/blood/epidemiology/*immunology
MH  - Venous Thromboembolism/blood/epidemiology/*immunology
OTO - NOTNLM
OT  - ANCA ASSOCIATED VASCULITIS
OT  - ENDOGENOUS THROMBIN POTENTIAL
OT  - THROMBOSIS
EDAT- 2013/10/17 06:00
MHDA- 2014/08/13 06:00
CRDT- 2013/10/17 06:00
PHST- 2013/10/17 06:00 [entrez]
PHST- 2013/10/17 06:00 [pubmed]
PHST- 2014/08/13 06:00 [medline]
AID - jrheum.130200 [pii]
AID - 10.3899/jrheum.130200 [doi]
PST - ppublish
SO  - J Rheumatol. 2013 Dec;40(12):2042-6. doi: 10.3899/jrheum.130200. Epub 2013 Oct 
      15.