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Evidence for an enhanced fibrinolytic capacity in cirrhosis as measured with two different global fibrinolysis tests.
MedLine Citation:
PMID:  22906184     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background & Objectives: It has been known for a long time that cirrhosis is associated with hyperfibrinolysis, which might contribute to an increased risk and severity of bleeding. However, recent papers have questioned the presence of a hyperfibrinolytic state in cirrhotic patients and postulated a rebalanced system due to concomitant changes in both pro- and anti-fibrinolytic factors. Therefore we re-investigated the fibrinolytic state of cirrhotic patients using two different overall tests including a recently developed test for global fibrinolytic capacity (GFC) using whole blood. Patients and Methods: Blood was collected from 30 healthy controls and 75 patients with cirrhosis of varying severity (34 Child-Pugh A, 28 Child-Pugh B and 13 Child-Pugh C). The plasma clot lysis time (CLT), which is inversely correlated with fibrinolysis, was determined as well as the GFC. Results: The mean CLT was 74.5 min in the controls and decreased significantly to 66.9 min in Child-Pugh class A patients, 59.3 min in class B patients and 61.0 min in class C patients, and hyperfibrinolysis existed in 40% of the patients. The median GFC was 1.7 μg/ml in the controls and increased significantly to 4.0 μg/ml in Child-Pugh class A patients, 11.1 μg/ml in class B patients and 22.5 μg/ml in class C patients, and hyperfibrinolysis existed in 43% of the patients. Taken together, 60% of the patients showed hyperfibrinolysis in at least one of the two global assays. Conclusion: A rebalanced fibrinolytic system may occur, but hyperfibrinolysis is found in the majority of patients with cirrhosis. © 2012 International Society on Thrombosis and Haemostasis.
Authors:
Dingeman C Rijken; Edith L Kock; Ana H C Guimarães; Simone Talens; Sarwa Darwish Murad; Harry L A Janssen; Frank W G Leebeek
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-20
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 International Society on Thrombosis and Haemostasis.
Affiliation:
Department of Hematology and Erasmus University Medical Center, Rotterdam, the Netherlands Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands.
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