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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R.


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Evaluation of pre-analytical, demographic, behavioural and metabolic variables on fibrinolysis and haemostasis activation markers utilised to assess hypercoagulability

Mojca Stegnar1 / Tjaša Vižintin Cuderman2 / Mojca Božič3

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Corresponding author: Prof. Dr. Mojca Stegnar, Department of Vascular Diseases, University Medical Centre, Zaloška 7, 1525 Ljubljana, Slovenia Phone: +386-1-5228052, Fax: +386-1-5228070,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 1, Pages 40–46, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2007.020, January 2007

Publication History

Received:
September 14, 2006
Accepted:
2006

Abstract

Background: Measurement of some haemostatic factors and products formed during activation of haemostasis seems to be promising in the determination of hypercoagulability.

Methods: The fibrinolytic variables euglobulin clot lysis time, tissue-type plasminogen activator, plasminogen activator inhibitor-1 and the haemostasis activation markers prothrombin fragment 1+2, thrombin-antithrombin complex and D-dimer were determined in 101 apparently healthy men and women aged 20–92 years (58±18 years, mean±SD) to establish variability due to several demographic, behavioural and metabolic factors.

Results: None of the fibrinolytic variables were affected by smoking, while tissue-type plasminogen activator antigen was significantly lower in women compared to men. Multiple regression analysis revealed several independent associations between tissue-type plasminogen activator, plasminogen activator inhibitor, body mass index and lipid levels, describing up to 40% of the variance in fibrinolytic variables. For haemostasis activation markers, no gender difference or effect of smoking was observed. Only D-dimer was independently associated with age. The haemostasis activation markers determined proved to be extremely sensitive to blood sampling procedure and were significantly higher in samples obtained by an untrained nurse compared to a trained nurse.

Conclusions: Fibrinolytic variables are predominantly modulated by age, body mass index and blood lipids, while haemostasis activation markers are mainly un-influenced by these factors.

Clin Chem Lab Med 2007;45:40–6.

Keywords: D-dimer; fibrinolysis; plasminogen activator inhibitor-1; prothrombin fragment 1+2; thrombin-antithrombin complex; tissue-type plasminogen activator

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