Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study

Abstract Background The severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure (mPAP) levels. However, other markers have not been elucidated. Fibrinolytic markers, such as total plasminogen activator inhibitor-1 (tPAI-1) and thrombomodulin (TM), are...

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Autores principales:	Makoto Shoji, Taiju Matsui, Hideaki Tanaka, Kosuke Nomura, Hiroaki Tsujita, Yusuke Kodama, Shinji Koba, Youichi Kobayashi, Toshiro Shinke
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	tPAI-1 Thrombomodulin Pulmonary artery hypertension Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/b918efd59aa74a9f860614cfa2bdc471
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spelling	oai:doaj.org-article:b918efd59aa74a9f860614cfa2bdc4712021-11-08T10:58:45ZFibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study10.1186/s12959-021-00332-41477-9560https://doaj.org/article/b918efd59aa74a9f860614cfa2bdc4712021-11-01T00:00:00Zhttps://doi.org/10.1186/s12959-021-00332-4https://doaj.org/toc/1477-9560Abstract Background The severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure (mPAP) levels. However, other markers have not been elucidated. Fibrinolytic markers, such as total plasminogen activator inhibitor-1 (tPAI-1) and thrombomodulin (TM), are known to reflect arterial endothelial function. However, the relationship between serum tPAI-1, TM and pulmonary circulation has not been completely determined. Methods This study included 100 consecutive patients (38 men), with a mean age of 68.9 ± 12.0 years, with cardiac diseases who underwent right heart catheterization. Serum coagulation and fibrinolytic marker levels were measured. Results The average mPAP value was 25.1 ± 13.1 mmHg for all patients. The mPAP levels revealed a significant positive correlation with serum tPAI-1 (ρ = 0.24, p = 0.042) and uric acid (ρ = 0.29, p = 0.0031) levels. In the group with mPAP levels less than 25 mmHg (n = 58, ave. 17.3 ± 4.3 mmHg), mPAP levels showed a significant positive correlation with serum tPA-1 (ρ = 0.34, p = 0.034) and TM (ρ = 0.34, p = 0.043) values. The mean tPAI-1 (29.8 ± 23.3 ng/ml, p = 0.047) and uric acid (5.7 ± 1.8 mg/dl, p = 0.026) levels were significantly less in those with lower mPAP levels. A multivariate analysis revealed that tPAI-1 alone was a significant independent characteristic marker of PAH (odds ratio 1.02, 95%CI 1.000–1.036, p = 0.034). Conclusions These results indicate that serum tPAI-1 and TM may be useful predictors of severity, similar to mPAP in patients with PAH. They could be beneficial in predicting PAH among patients in the early stage of the disease.Makoto ShojiTaiju MatsuiHideaki TanakaKosuke NomuraHiroaki TsujitaYusuke KodamaShinji KobaYouichi KobayashiToshiro ShinkeBMCarticletPAI-1ThrombomodulinPulmonary artery hypertensionDiseases of the blood and blood-forming organsRC633-647.5ENThrombosis Journal, Vol 19, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tPAI-1 Thrombomodulin Pulmonary artery hypertension Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	tPAI-1 Thrombomodulin Pulmonary artery hypertension Diseases of the blood and blood-forming organs RC633-647.5 Makoto Shoji Taiju Matsui Hideaki Tanaka Kosuke Nomura Hiroaki Tsujita Yusuke Kodama Shinji Koba Youichi Kobayashi Toshiro Shinke Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
description	Abstract Background The severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure (mPAP) levels. However, other markers have not been elucidated. Fibrinolytic markers, such as total plasminogen activator inhibitor-1 (tPAI-1) and thrombomodulin (TM), are known to reflect arterial endothelial function. However, the relationship between serum tPAI-1, TM and pulmonary circulation has not been completely determined. Methods This study included 100 consecutive patients (38 men), with a mean age of 68.9 ± 12.0 years, with cardiac diseases who underwent right heart catheterization. Serum coagulation and fibrinolytic marker levels were measured. Results The average mPAP value was 25.1 ± 13.1 mmHg for all patients. The mPAP levels revealed a significant positive correlation with serum tPAI-1 (ρ = 0.24, p = 0.042) and uric acid (ρ = 0.29, p = 0.0031) levels. In the group with mPAP levels less than 25 mmHg (n = 58, ave. 17.3 ± 4.3 mmHg), mPAP levels showed a significant positive correlation with serum tPA-1 (ρ = 0.34, p = 0.034) and TM (ρ = 0.34, p = 0.043) values. The mean tPAI-1 (29.8 ± 23.3 ng/ml, p = 0.047) and uric acid (5.7 ± 1.8 mg/dl, p = 0.026) levels were significantly less in those with lower mPAP levels. A multivariate analysis revealed that tPAI-1 alone was a significant independent characteristic marker of PAH (odds ratio 1.02, 95%CI 1.000–1.036, p = 0.034). Conclusions These results indicate that serum tPAI-1 and TM may be useful predictors of severity, similar to mPAP in patients with PAH. They could be beneficial in predicting PAH among patients in the early stage of the disease.
format	article
author	Makoto Shoji Taiju Matsui Hideaki Tanaka Kosuke Nomura Hiroaki Tsujita Yusuke Kodama Shinji Koba Youichi Kobayashi Toshiro Shinke
author_facet	Makoto Shoji Taiju Matsui Hideaki Tanaka Kosuke Nomura Hiroaki Tsujita Yusuke Kodama Shinji Koba Youichi Kobayashi Toshiro Shinke
author_sort	Makoto Shoji
title	Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
title_short	Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
title_full	Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
title_fullStr	Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
title_full_unstemmed	Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
title_sort	fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b918efd59aa74a9f860614cfa2bdc471
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Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study

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