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Thromb Haemost 2001; 85(03): 390-394
DOI: 10.1055/s-0037-1615594
Rapid Communications
Schattauer GmbH

Fibrinolytic Variables in Patients with Recurrent Venous Thrombosis: a Prospective Cohort Study

Mark A. Crowther
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
3   McMaster University, Department of Medicine
5   St Joseph’s Hospital, Hamilton, ON, Canada
,
Jeremy Roberts
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
,
Robin Roberts
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
4   McMaster University, Department of Clinical Epidemiology and Biostatistics
,
Marilyn Johnston
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
,
Pamela Stevens
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
,
Peter Skingley
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
4   McMaster University, Department of Clinical Epidemiology and Biostatistics
,
G. M. Patrassi
2   Institute of Medical Semeiotics, University of Padua Medical School; Padua, Italy
,
M. T. Sartori
2   Institute of Medical Semeiotics, University of Padua Medical School; Padua, Italy
,
Jack Hirsh
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
3   McMaster University, Department of Medicine
,
Paolo Prandoni
2   Institute of Medical Semeiotics, University of Padua Medical School; Padua, Italy
,
Jeffrey I. Weitz
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
3   McMaster University, Department of Medicine
,
Michael Gent
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
4   McMaster University, Department of Clinical Epidemiology and Biostatistics
,
Jeffrey S. Ginsberg
1   Hamilton Civic Hospitals Research Centre, Henderson General Hospital, Hamilton, ON, Canada
3   McMaster University, Department of Medicine
› Author Affiliations
Further Information

Publication History

Received 02 May 2000

Accepted after resubmission 25 September 2000

Publication Date:
08 December 2017 (online)

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Summary

To determine whether fibrinolytic testing predicts recurrent venous thrombosis, we have performed a prospective cohort study in which 303 patients with a first episode of venous thromboembolism underwent comprehensive fibrinolytic testing while receiving oral anticoagulants, and after anticoagulants had been discontinued. They were then followed for up to 3 years for recurrent venous thrombosis. No systematic differences in the levels or activity of type 1 plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (tPA) or euglobulin clot lysis times were detected between patients who did, or did not, suffer recurrent thrombosis. There were also no differences in these variables when patients whose initial thrombosis was idiopathic were compared to patients whose thrombosis occurred in the setting of a known thrombotic risk factor. Based on these results, neither measuring fibrinolytic parameters in patients with venous thromboembolism, nor modification of treatment based on the results of such testing, are justified. Our study also confirms that patients with idiopathic venous thromboembolism have a high risk of recurrence.

Keywords

Fibrinolysis - venous thrombosis - recurrent thrombosis - idiopathic venous thromboembolism - predictors
 

  • References

  • 1 Schulman S, Wiman B. The significance of hypofibrinolysis for the risk of recurrence of venous thromboembolism. Duration of Anticoagulation (DURAC) Trial Study Group. Thromb Haemost 1996; 75 (Suppl. 04) 607-11.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Levine MN, Hirsh J, Gent M, Turpie AG, Weitz JI, Ginsberg JS, Geerts W, Leclerc J, Neemeh J, Powers P. et al. Optimal duration of oral anticoagulant therapy: a randomized trial comparing four weeks with three months of warfarin in patients with proximal deep vein thrombosis. Thromb Haemost 1995; 74: 606-11.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Levine MN, Gent M, Hirsh J, Leclerc J, Anderson D, Weitz J, Ginsberg J, Turpie AG, Demers C, Kovacs M. et al. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. New England Journal of Medicine 1996; 334 (Suppl. 11) 677-81.
    CrossrefPubMedGoogle Scholar
  • 4 The Columbus Investigators.. Low-molecular weight heparin in the treatment of patients with venous thromboembolism. New England Journal of Medicine 1997; 337: 675-62.
    PubMedGoogle Scholar
  • 5 Hougie C, Williams WJ, Beutler E, Erslev AJ, Lichtman MA. editors. Hematology. Fourth ed. Toronto: McGraw-Hill; 1990: A40 Euglobulin Lysis Time. p. 1774-5.
    Google Scholar
  • 6 Prins MH, Hirsh J. A critical review of the evidence supporting a relationship between impaired fibrinolytic activity and venous thromboembolism. Archives of Internal Medicine 1991; 151: 1721-31.
    CrossrefPubMedGoogle Scholar