Document Detail


Interaction of fibrinolysis and prothrombotic risk factors in neonates, infants and children with and without thromboembolism and underlying cardiac disease. a prospective study.
MedLine Citation:
PMID:  11457466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the role of plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA) in children with an estimated risk of vascular occlusion reported to range from 7% to 16%, we conducted a prospective study in infants and children with underlying cardiac disease. One hundred and twenty-five children (neonate - 16 years) were investigated. In 9 infants out of the 125 children vascular occlusion occurred, closely related to cardiac catheterisation and arterial or venous lines during major cardiac surgery. Six of the nine neonates and infants with (n=6) and without (n=3) prothrombotic risk factors showed evidence of a basically impaired fibrinolytic system. Five of the nine infants showed increased PAI-1 clearly correlated to the 4G/4G genotype of the plasminogen activator-1 promoter polymorphism along with elevated t-PA concentration before the first diagnostic cardiac catheterisation was performed. One infant presented with increased t-PA concentration only. Five of the six children with reduced fibrinolytic capacity had further prothrombotic risk factors. Conclusion: Data of this study indicate that neonates and infants with underlying cardiac disease and basically increased PAI-1 due to the 4G/4G variant of the PAI-1 promoter polymorphism along with elevated t-PA levels in combination with further prothrombotic risk factors are at high risk of developing early thromboembolism during cardiac catheterisation.
Authors:
U Nowak-Göttl; S Kotthoff; E Hagemeyer; R Junker; H G Kehl; H Vielhaber; D Kececioglu
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Thrombosis research     Volume:  103     ISSN:  0049-3848     ISO Abbreviation:  Thromb. Res.     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-17     Completed Date:  2001-12-04     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-101     Citation Subset:  IM    
Affiliation:
Pediatric Hematology and Oncology, University Hospital Münster, D-48149 Münster, Germany. leagottl@uni-muenster.de
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MeSH Terms
Descriptor/Qualifier:
3' Untranslated Regions / genetics
Adolescent
Case-Control Studies
Catheterization, Central Venous / adverse effects
Catheters, Indwelling / adverse effects
Child
Child, Preschool
Factor V / genetics
Fibrinolysis*
Gene Frequency
Genetic Predisposition to Disease
Genotype
Germany / epidemiology
Heart Catheterization / adverse effects*
Heart Defects, Congenital / blood*,  surgery
Humans
Infant
Infant, Newborn
Lipoprotein(a) / genetics
Plasminogen Activator Inhibitor 1 / genetics,  physiology*
Polymorphism, Genetic
Prevalence
Promoter Regions, Genetic / genetics
Prospective Studies
Protein C Deficiency / epidemiology,  genetics
Prothrombin / genetics
Risk Factors
Thromboembolism / epidemiology*,  etiology
Thrombophilia / epidemiology*,  genetics
Tissue Plasminogen Activator / physiology*
Chemical
Reg. No./Substance:
0/3' Untranslated Regions; 0/Lipoprotein(a); 0/Plasminogen Activator Inhibitor 1; 0/factor V Leiden; 9001-24-5/Factor V; 9001-26-7/Prothrombin; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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