Factors influencing the level of circulating procoagulant microparticles in acute pulmonary embolism
Factors influencing the level of circulating procoagulant microparticles in acute pulmonary embolism
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DOI：
10.1016/j.acvd.2010.06.005
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发表时间：
2010-06-01
影响因子：
3
通讯作者：
Cohen, Ariel
中科院分区：
文献类型：
--
作者：
Bal, Laurence;Ederhy, Stephane;Cohen, Ariel
流式细胞术显示血小板衍生微粒（PMPs）和内皮衍生微粒（EMPs）的水平在深静脉血栓形成中升高。目的通过病例对照研究，探讨肺栓塞和心血管危险因素对循环促凝微粒（CPMPs）所致高凝状态的影响。（年龄67.9±11.6岁; 66.7%为男性）因急性肺栓塞（APE）入住重症监护室，45例无静脉血栓栓塞或血管风险因素病史的健康对照受试者（ControlsnoCVRF）和45例有心血管风险因素的患者（ControlsCVRF）。APE通过螺旋计算机断层扫描或动脉造影诊断。使用凝血酶原酶测定法对血小板耗竭血浆评估CPMP水平（结果表示为nmol/L当量）APE患者的CPMP水平高于对照snoCVRF（中位数4.7 vs 3.2nmol/L，四分位数间距[IQRs] 2.9-11.1 vs 2.3-4.6nmol/L; p=0.02）。PMP报告了类似的结果（中位数2.2 vs 1.9 nmol/L，IQRs 1.7-5.8 vs 1.4- 2.4 nmol/L; p=0.02），而EMP水平无显著差异。然而，CPMP促凝血活性在APE患者和ControlsCVRFs.CONCLUSIONSCPMPs和PMPs显着升高，APE患者与ControlsCVRFs相比，但这种相关性并不显着。我们的观察结果强调了在微粒水平升高的情况下调整心血管危险因素的重要性。
BACKGROUNDFlow cytometry has shown levels of platelet-derived microparticles (PMPs) and endothelial-derived microparticles (EMPs) to be elevated in deep-vein thrombosis. Cardiovascular risk factors can also contribute to hypercoagulability due to circulating procoagulant microparticles (CPMPs).AIMSTo investigate in a case-control study the respective contribution of pulmonary embolism and cardiovascular risk factors to the level of hypercoagulability due to CPMPs.METHODSCPMP, PMP and EMP levels were measured in 45 consecutive patients (age 67.9±11.6 years; 66.7% men) admitted to an intensive care unit for acute pulmonary embolism (APE), 45 healthy control subjects with no history of venous thromboembolism or vascular risk factors (ControlsnoCVRFs), and 45 patients with cardiovascular risk factors (ControlsCVRFs). APE was diagnosed by spiral computed tomography or scintigraphy. CPMP levels were assessed using a prothrombinase assay on platelet-depleted plasma (results expressed as nmol/L equivalent).RESULTSCPMP levels were higher in APE patients than in ControlsnoCVRFs(medians 4.7 vs 3.2nmol/L, interquartile ranges [IQRs] 2.9–11.1 vs 2.3–4.6nmol/L; p=0.02). Similar results were reported for PMPs (medians 2.2 vs 1.9nmol/L, IQRs 1.7–5.8 vs 1.4–2.4nmol/L; p=0.02), whereas EMP levels were not significantly different. However, CPMP procoagulant activity was not significantly different in APE patients and ControlsCVRFs.CONCLUSIONSCPMPs and PMPs were significantly elevated in APE patients vs ControlsnoCVRFs, but this correlation was not significant when APE patients were compared with ControlsCVRFs. Our observations highlight the importance of adjusting for the presence of cardiovascular risk factors in conditions in which microparticle levels are raised.