Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.

Venous thromboembolism (VTE) is a chronic disease, which tends to recur. Whether an abnormal fibrinolytic system is associated with an increased risk of VTE is unclear. We assessed the relationship between fibrinolytic capacity (reflected by clot lysis time [CLT]) and risk of recurrent VTE. We follo...

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Autores principales:	Ludwig Traby, Marietta Kollars, Lisbeth Eischer, Sabine Eichinger, Paul A Kyrle
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/32ad12cb0d5b4d9eb80f2d395089ad88
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spelling	oai:doaj.org-article:32ad12cb0d5b4d9eb80f2d395089ad882021-11-18T08:05:34ZPrediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.1932-620310.1371/journal.pone.0051447https://doaj.org/article/32ad12cb0d5b4d9eb80f2d395089ad882012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23240024/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203Venous thromboembolism (VTE) is a chronic disease, which tends to recur. Whether an abnormal fibrinolytic system is associated with an increased risk of VTE is unclear. We assessed the relationship between fibrinolytic capacity (reflected by clot lysis time [CLT]) and risk of recurrent VTE. We followed 704 patients (378 women; mean age 48 yrs) with a first unprovoked VTE for an average of 46 months after anticoagulation withdrawal. Patients with natural coagulation inhibitor deficiency, lupus anticoagulant, cancer, homozygosity for factor V Leiden or prothrombin mutation, or requirement for indefinite anticoagulation were excluded. Study endpoint was symptomatic recurrent VTE. For measurement of CLT, a tissue factor-induced clot was lysed by adding tissue-type plasminogen activator. Time between clot formation and lysis was determined by measuring the turbidity. 135 (19%) patients had recurrent VTE. For each increase in CLT of 10 minutes, the crude relative risk (RR) of recurrence was 1.13 (95% CI 1.02-1.25; p = 0.02) and was 1.08 (95% CI 0.98-1.20; p = 0.13) after adjustment for age and sex. For women only, the adjusted RR was 1.14 (95% CI, 0.91-1.42, p = 0.22) for each increase in CLT of 10 minutes. CLT values in the 4(th) quartile of the female patient population, as compared to values in the 1(st) quartile, conferred a risk of recurrence of 3.28 (95% CI, 1.07-10.05; p = 0.04). No association between CLT and recurrence risk was found in men. Hypofibrinolysis as assessed by CLT confers a moderate increase in the risk of recurrent VTE. A weak association between CLT and risk of recurrence was found in women only.Ludwig TrabyMarietta KollarsLisbeth EischerSabine EichingerPaul A KyrlePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 12, p e51447 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ludwig Traby Marietta Kollars Lisbeth Eischer Sabine Eichinger Paul A Kyrle Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
description	Venous thromboembolism (VTE) is a chronic disease, which tends to recur. Whether an abnormal fibrinolytic system is associated with an increased risk of VTE is unclear. We assessed the relationship between fibrinolytic capacity (reflected by clot lysis time [CLT]) and risk of recurrent VTE. We followed 704 patients (378 women; mean age 48 yrs) with a first unprovoked VTE for an average of 46 months after anticoagulation withdrawal. Patients with natural coagulation inhibitor deficiency, lupus anticoagulant, cancer, homozygosity for factor V Leiden or prothrombin mutation, or requirement for indefinite anticoagulation were excluded. Study endpoint was symptomatic recurrent VTE. For measurement of CLT, a tissue factor-induced clot was lysed by adding tissue-type plasminogen activator. Time between clot formation and lysis was determined by measuring the turbidity. 135 (19%) patients had recurrent VTE. For each increase in CLT of 10 minutes, the crude relative risk (RR) of recurrence was 1.13 (95% CI 1.02-1.25; p = 0.02) and was 1.08 (95% CI 0.98-1.20; p = 0.13) after adjustment for age and sex. For women only, the adjusted RR was 1.14 (95% CI, 0.91-1.42, p = 0.22) for each increase in CLT of 10 minutes. CLT values in the 4(th) quartile of the female patient population, as compared to values in the 1(st) quartile, conferred a risk of recurrence of 3.28 (95% CI, 1.07-10.05; p = 0.04). No association between CLT and recurrence risk was found in men. Hypofibrinolysis as assessed by CLT confers a moderate increase in the risk of recurrent VTE. A weak association between CLT and risk of recurrence was found in women only.
format	article
author	Ludwig Traby Marietta Kollars Lisbeth Eischer Sabine Eichinger Paul A Kyrle
author_facet	Ludwig Traby Marietta Kollars Lisbeth Eischer Sabine Eichinger Paul A Kyrle
author_sort	Ludwig Traby
title	Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
title_short	Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
title_full	Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
title_fullStr	Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
title_full_unstemmed	Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
title_sort	prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/32ad12cb0d5b4d9eb80f2d395089ad88
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Prediction of recurrent venous thromboembolism by clot lysis time: a prospective cohort study.

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