No increased systemic fibrinolysis in women with heavy menstrual bleeding
| Autor: | Johanna Kluin-Nelemans, Dick H. Bogchelman, Sophie Wiewel-Verschueren, Andre B. Mulder, van der Ate Zee, H. M. Knol, Karina Meijer, Ton Lisman |
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| Přispěvatelé: | Damage and Repair in Cancer Development and Cancer Treatment (DARE), Groningen Institute for Organ Transplantation (GIOT), Vascular Ageing Programme (VAP), Stem Cell Aging Leukemia and Lymphoma (SALL), Targeted Gynaecologic Oncology (TARGON) |
| Rok vydání: | 2014 |
| Předmět: |
TAFI
Adult Carboxypeptidase B2 medicine.medical_specialty Plasmin medicine.medical_treatment clot lysis time Hemorrhage Endometrium Gastroenterology Fibrin Body Mass Index Menstruation chemistry.chemical_compound BLOOD-LOSS Internal medicine Plasminogen Activator Inhibitor 1 Fibrinolysis Humans Medicine fibrin CYCLE Blood Coagulation Menorrhagia RISK LYSIS Hemostasis biology business.industry TRANEXAMIC ACID Hematology Middle Aged Healthy Volunteers Surgery medicine.anatomical_structure chemistry Case-Control Studies Plasminogen activator inhibitor-1 biology.protein thrombin-activatable fibrinolysis inhibitor Female Blood Coagulation Tests business Plasminogen activator Tranexamic acid medicine.drug |
| Zdroj: | Journal of Thrombosis and Haemostasis, 12(9), 1488-1493. Wiley |
| ISSN: | 1538-7836 1538-7933 |
| DOI: | 10.1111/jth.12645 |
| Popis: | BackgroundBleeding disorders have been recognized as important etiologic or contributory factors in women with heavy menstrual bleeding. Fibrinolysis in the endometrium plays a role in heavy menstrual bleeding. It is unknown whether increased systemic fibrinolysis might also increase the risk of heavy menstrual bleeding.ObjectiveTo investigate fibrinolytic parameters, including clot lysis time, in women with heavy menstrual bleeding.MethodsWe included 102 patients referred for heavy menstrual bleeding (Pictorial Bleeding Assessment Chart score of >100) in our cohort. Patients and controls (28 healthy volunteers without heavy menstrual bleeding) underwent hemostatic testing in the first week after menstruation. For 79 patients and all controls, fibrinolytic parameters (thrombin-activatable fibrinolysis inhibitor activity, and plasminogen activator inhibitor-1, tissue-type plasminogen activator and plasmin inhibitor levels) and clot lysis time were available.ResultsFibrinolytic parameters were similar between patients and controls, except for thrombin-activatable fibrinolysis inhibitor (89.4% vs. 82.5%) and plasmin inhibitor (106% vs. 96%), the levels of which which were significantly higher in patients. In women with menorrhagia without gynecologic abnormalities, we found lower thrombin-activatable fibrinolysis inhibitor and plasminogen activator inhibitor-1 levels than in women with gynecologic abnormalities (thrombin-activatable fibrinolysis inhibitor, 85.4% vs. 94.8%; plasminogen activator inhibitor-1, 16.0gL(-1) vs. 24.5gL(-1)).ConclusionSystemic fibrinolytic capacity is not increased in women with heavy menstrual bleeding. Overall, levels of the fibrinolytic inhibitors thrombin-activatable fibrinolysis inhibitor and plasmin inhibitor were even higher in patients than in controls. However, in a subgroup of women without gynecologic abnormalities, relatively lower levels of inhibitors may contribute to the heavy menstrual bleeding. |
| Databáze: | OpenAIRE |
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