Prolonged clot lysis time increases the risk of a first but not recurrent venous thrombosis

British Journal of Haematology
Alev KarasuA van Hylckama Vlieg

Abstract

The role of the fibrinolytic system in the development of venous thrombosis (VT) is unclear. We studied the risk of first and recurrent VT associated with reduced fibrinolysis, as measured by clot lysis time (CLT). We also studied the relationship between CLT and thrombin generation to determine if any relationship between CLT and VT was affected by thrombin generation. Analyses were performed in the Thrombophilia Hypercoagulability Environmental risk for Venous Thromboembolism Study, a two-centre population-based case-control study, including 579 patients and 338 controls, with patients followed from the event to determine incidence of recurrent VT. Hypofibrinolysis was associated with a 1·8-fold increased risk of a first VT [95% confidence interval (CI) 1·2-2·7]. Adjustment for sex, age, study location and Endogenous Thrombin Potential (ETP) did not change the result. The risk of VT was 2·9-fold increased when the 90th percentiles of prolonged CLT and high ETP were combined, with the highest risk for unprovoked first events (Odds Ratio = 4·2, 95% CI 1·3-13·5). In the follow-up study the Hazard Ratio for a recurrent VT associated with hypofibrinolysis was 1·5 (95% CI 0·9-2·6). A weak dose response effect was observed in relati...Continue Reading

References

Jul 11, 2003·Pathophysiology of Haemostasis and Thrombosis·H Coenraad HemkerSuzette Béguin
Apr 7, 2007·Current Opinion in Hematology·Mirjam E MeltzerTon Lisman
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Citations

Mar 21, 2017·Journal of the American College of Surgeons·Belinda H McCullyUNKNOWN PROPPR Study Group
Jul 20, 2017·International Journal of Laboratory Hematology·Ton Lisman
Apr 18, 2020·British Journal of Haematology·Suzanne Schol-GelokMarieke J H A Kruip
Dec 10, 2020·European Journal of Clinical Investigation·Rahim KanjiDiana A Gorog
Jun 30, 2021·Proceedings of the National Academy of Sciences of the United States of America·Cédric DuvalRobert A S Ariëns

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