Plasma Fibrin Clot Properties as Determinants of Bleeding Time in Human Subjects: Association with Histidine-Rich Glycoprotein.

Konstanty Szułdrzyński,Daniel P Potaczek,Miłosz Jankowski,Anetta Undas

doi:10.1155/2020/7190828

Konstanty Szułdrzyński, Daniel P Potaczek + Show 2 more

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https://doi.org/10.1155/2020/7190828

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Abstract

Aims Fibrin formation and histidine-rich glycoprotein (HRG) are involved in primary hemostasis and wound healing. Little is known regarding the relationship of clot characteristics, bleeding time, and wound healing. Methods and Results We studied 154 patients with coronary artery disease (CAD) and 154 subjects free of CAD matched for age, obesity, and current smoking. We evaluated bleeding time (BT) using standardized skin incisions on a forearm, along with plasma clot permeability (Ks), clot lysis time (CLT), and histidine-rich glycoprotein (HRG). Compared with controls, BT was 45% shorter in CAD cases. CAD patients had 32% lower Ks), clot lysis time (CLT), and histidine-rich glycoprotein (HRG). Compared with controls, BT was 45% shorter in CAD cases. CAD patients had 32% lower p < 0.001). After adjusting for potential confounders, Ks), clot lysis time (CLT), and histidine-rich glycoprotein (HRG). Compared with controls, BT was 45% shorter in CAD cases. CAD patients had 32% lower n = 79, 25.6%) was independently predicted by both short and prolonged BT in CAD cases (OR 21.87, 95% CI 7.41-64.55 and OR 10.17, 95% CI 2.88-35.97) and controls (OR 5.94, 95% CI 2.29-15.41 and OR 14.76, 95% CI 4.29-50.77, respectively). Conclusions The study shows that plasma fibrin clot density and HRG may influence BT and that appropriate skin wound healing is associated with medium BT. Translational Perspective. Elucidation of the complex relationships between plasma fibrin clot phenotype and wound healing might have important practical implications.

Highlights

Fibrin formation is the final step of blood coagulation involved in hemostasis following vascular injury and the maintenance of vessel patency under pathological conditions
We demonstrated that Ks is an independent predictor of longer BT in both studied groups suggesting that fibrin network density affects bleeding time and has the impact on the primary hemostasis
Another novel finding is that elevated histidine-rich glycoprotein (HRG) in circulating blood correlates with longer BT in humans, which suggests that this abundant protein may affect primary hemostasis at least in part through its impact on fibrin clot structure

Summary

Introduction

Fibrin formation is the final step of blood coagulation involved in hemostasis following vascular injury and the maintenance of vessel patency under pathological conditions. There is evidence that plasma fibrin clots composed of compact networks that are less susceptible to lysis, the so-called “prothrombotic clot phenotype,” can be observed in patients with myocardial infarction (MI), ischemic stroke, and peripheral artery disease [1, 2]. Unfavourable fibrin clot characteristics were found in patients with cardiovascular risk factors, including cigarette smoking [3], diabetes mellitus. Disease Markers [4], and arterial hypertension [5]. The impact of environmental factors is considered prevalent in the prothrombotic plasma clot phenotype [6, 7]. In particular aspirin and statins, have been reported to increase clot permeability and susceptibility to lysis [8, 9]. Recent studies have suggested that clot properties may predict recurrent thrombosis [10]

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