Plasma thrombin-antithrombin complex, prothrombin fragments 1 and 2, and D-dimer levels are elevated after endovascular but not open repair of infrarenal abdominal aortic aneurysm.
Plasma thrombin-antithrombin complex, prothrombin fragments 1 and 2, and D-dimer levels are elevated after endovascular but not open repair of infrarenal abdominal aortic aneurysm.
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肾下腹主动脉瘤血管内修复而非开放修复后，血浆凝血酶-抗凝血酶复合物、凝血酶原片段 1 和 2 以及 D-二聚体水平升高。
DOI：
10.1016/j.jvs.2012.12.030
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发表时间：
2013
影响因子：
4.3
通讯作者：
D. Scott
中科院分区：
文献类型：
--
作者：
Marc A. Bailey;Kathryn J. Griffin;S. Sohrabi;Daniel Whalley;Anne B Johnson;Paul D. Baxter;R. A. Ariëns;D. Scott
腹主动脉瘤（AAA）与高凝状态有关，表现为凝血激活标志物增加，包括凝血酶-抗凝血酶复合物（达特）、凝血酶原片段1和2（F1+2）和D-二聚体。我们的目的是比较动脉瘤腔内修复术（EVAR）和开放性动脉瘤修复术（OAR）对介入后凝血激活标记物变化的影响。在基线和干预后5个月采集静脉血，测定凝血标志物达特、F1+2和D-二聚体。采用前向逐步多元线性回归模型来确定OAR或EVAR治疗是否对凝血因子的变化有影响，独立于显著的协变量。研究包括47名患者（14名EVAR，33名OAR; 85%男性），中位年龄为76岁（范围，69.5-80岁）。介入时的主动脉直径为5.9 cm（范围：5.5-6.8 cm）。两组之间的临床、人体测量或血液学参数无显著差异。在基线时，腹主动脉瘤腔内修复术和OAR患者的达特（P = 0.13）、F1+2（P = 0.08）和D-二聚体（P = 0.11）相似。干预后，达特显著增加，（3.0 [2.1-6.0] vs 7.2 [6.3-8.4] ng/mL; P = .03），F1+2腹主动脉瘤腔内修复术组中的（242 [189-323] vs 392 [312-494] ng/mL; P = .003）和D-二聚体（457 [336-615] vs 1197 [840-1509] ng/mL; P = .002）。干预后OAR group. CONCLUSIONSAA相关的高凝状态持续干预后，增加达特，F1+2，和D-二聚体水平腹主动脉瘤腔内修复术后，没有观察到显着变化。这些结果表明腹主动脉瘤腔内修复术后心血管风险可能增加。
INTRODUCTIONAbdominal aortic aneurysm (AAA) is associated with hypercoagulability, evidenced by increased markers of coagulation activation, including thrombin-antithrombin complex (TAT), prothrombin fragments 1 and 2 (F1+2), and D-dimer. Our aim was to compare the effect of endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) on changes in coagulation activation markers after intervention.METHODSConsecutive patients with AAAs reaching their intervention threshold in a tertiary vascular referral unit in the United Kingdom were invited to participate. The coagulation markers TAT, F1+2, and D-dimer were measured in venous blood collected at baseline and at 5 months after intervention. A forward stepwise multiple linear regression model was used to identify whether treatment by OAR or EVAR had an effect on changes in coagulation factors, independent of significant covariates.RESULTSThe study included 47 patients (14 EVAR, 33 OAR; 85% men) who were a median age of 76 years (range, 69.5-80 years). Aortic diameter at intervention was 5.9 cm (range, 5.5-6.8 cm). There were no significant differences in clinical, anthropometric, or hematologic parameters between groups. At baseline, TAT (P = .13), F1+2 (P = .08), and D-dimer (P = .11) were similar in EVAR and OAR patients. Postintervention, there was a significant increase in TAT (3.0 [2.1-6.0] vs 7.2 [6.3-8.4] ng/mL; P = .03), F1+2 (242 [189-323] vs 392 [312-494] ng/mL; P = .003), and D-dimer (457 [336-615] vs 1197 [840-1509] ng/mL; P = .002) in the EVAR group. No significant changes were observed after intervention in the OAR group.CONCLUSIONSAAA-related hypercoagulability persists after intervention, with increased TAT, F1+2, and D-dimer levels after EVAR. These findings suggest a potential period of increased cardiovascular risk in the postoperative period after EVAR.
影响因子：
4.3
作者：
Parr, Adam;McCann, Moira;Bradshaw, Barbara;Shahzad, Anwar;Buttner, Petra;Golledge, Jonathan
通讯作者：
Golledge, Jonathan