Document Detail


Prethrombotic state due to hypercoagulability in patients with permanent transvenous pacemakers.
MedLine Citation:
PMID:  9342969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Venous thrombosis is a relatively usual but serious complication of permanent transvenous pacing. However, the pathogenesis has not been defined. To clarify underlying abnormalities in the coagulation-fibrinolysis system in patients with permanent transvenous pacemakers, we measured serum levels of fibrinopeptide A (FPA), thrombin-antithrombin III complexes (TATs), plasmin-alpha 2 plasmin inhibitor complexes (PICs), D-dimer (D-D), beta-thromboglobulin (beta-TG), and platelet factor 4 (PF4) in 53 patients with permanent transvenous pacemakers and 10 control subjects. The patients were divided into two groups, as follows, according to the presence of mural thrombus documented along the pacing lead(s) by digital subtraction angiography and transesophageal echocardiography: Group Th (-), patients without venous route thrombus; and Group Th (+), patients with venous route thrombus. FPA and TAT levels increased significantly even in Group Th (-), and further increased in Group Th (+) compared with control subjects (FPA: 7.5 +/- 4.9, 15.3 +/- 8.8 vs 3.0 +/- 1.4 ng/mL, respectively, P < 0.05; TAT: 2.9 +/- 1.3, 4.8 +/- 2.3 vs 1.7 +/- 0.6 ng/mL, respectively, P < 0.05). There were no differences in levels of D-D, PIG, beta-TG, and PF4 among control subjects, Group Th (-), and Group Th (+). These findings suggest that the hypercoagulable state appears in patients with permanent transvenous pacemakers, even without apparent venous thrombosis. The patients with permanent transvenous pacemakers are thought to be in the prethrombotic state even if they have no venous route thrombosis.
Authors:
T Ito; J Tanouchi; J Kato; M Nishino; K Iwai; H Tanahashi; M Hori; Y Yamada; T Kamada
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Angiology     Volume:  48     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-11-18     Completed Date:  1997-11-18     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  901-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Osaka Rosai Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography, Digital Subtraction
Antifibrinolytic Agents / blood
Antithrombin III / analysis
Blood Coagulation / physiology*
Cardiac Pacing, Artificial / adverse effects
Echocardiography, Transesophageal
Female
Fibrin Fibrinogen Degradation Products / analysis
Fibrinolysin / analysis
Fibrinolysis / physiology
Fibrinolytic Agents / blood
Fibrinopeptide A / analysis
Heart Diseases / blood,  etiology,  radiography,  ultrasonography
Humans
Male
Middle Aged
Pacemaker, Artificial / adverse effects*
Peptide Hydrolases / analysis
Platelet Factor 4 / analysis
Serine Proteinase Inhibitors / blood
Thrombophlebitis / blood,  etiology
Thrombosis / blood,  etiology*,  radiography,  ultrasonography
alpha-2-Antiplasmin / analysis
beta-Thromboglobulin / analysis
Chemical
Reg. No./Substance:
0/Antifibrinolytic Agents; 0/Fibrin Fibrinogen Degradation Products; 0/Fibrinolytic Agents; 0/Serine Proteinase Inhibitors; 0/alpha-2-Antiplasmin; 0/antithrombin III-protease complex; 0/beta-Thromboglobulin; 0/fibrin fragment D; 25422-31-5/Fibrinopeptide A; 37270-94-3/Platelet Factor 4; 9000-94-6/Antithrombin III; EC 3.4.-/Peptide Hydrolases; EC 3.4.21.7/Fibrinolysin

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