PMID- 32651425
OWN - NLM
STAT- MEDLINE
DCOM- 20210111
LR  - 20210710
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 10
IP  - 1
DP  - 2020 Jul 10
TI  - Prothrombotic fibrin clot properties associated with NETs formation characterize 
      acute pulmonary embolism patients with higher mortality risk.
PG  - 11433
LID - 10.1038/s41598-020-68375-7 [doi]
LID - 11433
AB  - Venous thromboembolism is associated with formation of denser fibrin clots 
      resistant to lysis. We investigated whether prothrombotic plasma clot properties 
      are associated with the severity of acute pulmonary embolism (PE). We enrolled 
      126 normotensive acute PE patients (aged 58 +/- 14 years) and 25 age- and 
      sex-matched healthy controls. Plasma fibrin clot permeability (K(s)), clot lysis 
      time (CLT), endogenous thrombin potential (ETP), plasminogen activator 
      inhibitor-1 (PAI-1), and citrullinated histone H3 (citH3) were evaluated on 
      admission. PE patients compared to controls had 370% higher citH3 levels, 41% 
      higher ETP, 16.5% reduced K(s), and 25.6% prolonged CLT. Patients with 
      intermediate-high (n = 29) and intermediate-low (n = 77) PE mortality risk had 
      reduced K(s) and prolonged CLT, increased PAI-1 and ETP as compared to low-risk 
      PE (n = 20) patients. Prolonged CLT was predicted by PAI-1 and citH3, while low 
      K(s) by C-reactive protein. During a 12-month follow-up 9 (7.1%) patients who had 
      24% higher ETP, 45% higher citH3 levels, and 18% prolonged CLT at baseline died. 
      High ETP combined with elevated citH3 levels and prolonged CLT was associated 
      with eightfold increased risk of PE-related death. Prothrombotic fibrin clot 
      properties and enhanced neutrophil extracellular traps formation are associated 
      with higher early mortality risk in acute PE patients, which suggests a 
      prognostic role of these biomarkers.
FAU - Zabczyk, Michal
AU  - Zabczyk M
AD  - Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka 
      St.,, 31-202, Krakow, Poland.
AD  - John Paul II Hospital, Krakow, Poland.
FAU - Natorska, Joanna
AU  - Natorska J
AD  - Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka 
      St.,, 31-202, Krakow, Poland.
AD  - John Paul II Hospital, Krakow, Poland.
FAU - Janion-Sadowska, Agnieszka
AU  - Janion-Sadowska A
AD  - The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, 
      Kielce, Poland.
FAU - Metzgier-Gumiela, Agnieszka
AU  - Metzgier-Gumiela A
AD  - Provincial Polyclinical Hospital, Torun, Poland.
FAU - Polak, Mateusz
AU  - Polak M
AD  - First Department of Cardiology, Leszek Giec Upper-Silesian Medical Centre of the 
      Silesian Medical University, Katowice, Poland.
FAU - Plens, Krzysztof
AU  - Plens K
AD  - KCRI, Krakow, Poland.
FAU - Janion, Marianna
AU  - Janion M
AD  - The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, 
      Kielce, Poland.
FAU - Skonieczny, Grzegorz
AU  - Skonieczny G
AD  - Provincial Polyclinical Hospital, Torun, Poland.
FAU - Mizia-Stec, Katarzyna
AU  - Mizia-Stec K
AD  - First Department of Cardiology, Leszek Giec Upper-Silesian Medical Centre of the 
      Silesian Medical University, Katowice, Poland.
FAU - Undas, Anetta
AU  - Undas A
AD  - Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka 
      St.,, 31-202, Krakow, Poland. mmundas@cyf-kr.edu.pl.
AD  - John Paul II Hospital, Krakow, Poland. mmundas@cyf-kr.edu.pl.
AD  - The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, 
      Kielce, Poland. mmundas@cyf-kr.edu.pl.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200710
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Biomarkers)
RN  - 0 (Histones)
RN  - 0 (Plasminogen Activator Inhibitor 1)
RN  - 0 (SERPINE1 protein, human)
RN  - 9001-31-4 (Fibrin)
RN  - EC 3.4.21.5 (Thrombin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers
MH  - Blood Coagulation Tests
MH  - Case-Control Studies
MH  - *Extracellular Traps
MH  - Female
MH  - Fibrin/chemistry
MH  - Fibrin Clot Lysis Time
MH  - Fibrinolysis
MH  - Follow-Up Studies
MH  - Histones/blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Plasminogen Activator Inhibitor 1/blood
MH  - Prognosis
MH  - Pulmonary Embolism/*blood/mortality
MH  - Risk
MH  - Sensitivity and Specificity
MH  - Thrombin/metabolism
MH  - Thrombosis/*blood
MH  - Venous Thromboembolism/blood/mortality
PMC - PMC7351737
COIS- The authors declare no competing interests.
EDAT- 2020/07/12 06:00
MHDA- 2021/01/12 06:00
PMCR- 2020/07/10
CRDT- 2020/07/12 06:00
PHST- 2019/10/29 00:00 [received]
PHST- 2020/02/12 00:00 [accepted]
PHST- 2020/07/12 06:00 [entrez]
PHST- 2020/07/12 06:00 [pubmed]
PHST- 2021/01/12 06:00 [medline]
PHST- 2020/07/10 00:00 [pmc-release]
AID - 10.1038/s41598-020-68375-7 [pii]
AID - 68375 [pii]
AID - 10.1038/s41598-020-68375-7 [doi]
PST - epublish
SO  - Sci Rep. 2020 Jul 10;10(1):11433. doi: 10.1038/s41598-020-68375-7.