Mean Values Of Fibrinogen Research Articles

Blood Levels of Glycated Hemoglobin, D-Dimer, and Fibrinogen in Diabetic Retinopathy.

PurposeThis study aimed to describe the levels of glycated hemoglobin (HbA1c), D-dimer (D-D), and fibrinogen (FIB) in different types of diabetic retinopathy (DR).MethodsA total of 61 patients with diabetes, who were treated in our department between November 2017 and May 2019, were selected. According to their non-mydriatic fundus photography and fundus angiography results, patients were divided into three groups, ie, the non-DR (NDR) group (n=23), the non-proliferative DR (NPDR) group (n=17), and the proliferative DR (PDR) group (n=21). A control group of 20 people who had tested negative for diabetes was also included. The levels of HbA1c, D-D, and FIB were measured and compared, respectively.ResultsThe mean values of HbA1c were 6.8% (5.2%, 7.7%), 7.4% (5.8%, 9.0%), and 8.5% (6.3%, 9.7%) in the NDR, NPDR, and PDR groups, respectively. The control group values were 4.9% (4.1%, 5.8%). These results indicated a significant statistical difference between groups. The mean values of D-D were 0.39 ± 0.21 mg/L, 1.06 ± 0.54 mg/L, and 1.39 ± 0.59 mg/L in the NDR, NPDR, and PDR groups, respectively. The control group result was 0.36 ± 0.17 mg/L. The values of the NPDR and PDR groups were significantly higher than those of the NDR and control groups, and the value of the PDR group was significantly higher than that of the NPDR group, indicating a significant difference between the groups (P < 0.001). The mean values of FIB were 3.07 ± 0.42 g/L, 4.38 ± 0.54 g/L, and 4.46 ± 1.09 g/L in the NDR, NPDR, and PDR groups, respectively. The control group result was 2.97 ± 0.67 g/L. The difference between the groups was statistically significant (P < 0.05).ConclusionBlood levels of HbA1c, D-D, and FIB in the PDR group were significantly higher than in the NPDR group.

To Study the Coagulation Profile Derangements in Metabolic Syndrome

Introduction: The metabolic syndrome is a complex disorder characterized by the presence of a clustering of metabolic risk factors usually in a single individual associated with the presence of central obesity and a strong association with diabetes and cardiovascular disease morbidity and mortality. It is a fast spreading global pandemic &amp; emerging as a public health problem with poor outcome and Quality of life thus more predilection is towards preventive than curative treatment. According to WHO Clinical Criteria, Metabolic syndrome is defined as insulin resistance, identified by 1 of the following, Type 2 diabetes, fasting blood glucose more than 110 mg/dl plus any 2 of the following: antihypertensive medication and /or high blood pressure &gt; 140 mm systolic or &gt;90 mm diastolic, plasma triglyceride (TG) level more than 150 mg/dl (1.7 mmol/L), high-density lipoprotein (HDL) cholesterol level less than 35 mg/dl (0.9 mmol/L) in men or less than 39 (1.0 mmol/L)in women , BMI &gt;30 kg/m2 and/or waist:hip ratio &gt;0.9 in men, &gt; 0.85 in women, Urinary albumen excretion rate &gt; 20 mcg/min or albumin:creatinine ratio&gt;30mg/g Aims &amp; Objectives: To investigate the coagulation profile derangements in metabolic syndrome. To study the relationship of various components of metabolic syndrome with coagulation parameters. Material &amp; Methods: This was a prospective cross-sectional study carried out in Haematology &amp; Medicine Deptt of SafdarJang Hospital, New Delhi. After taking consent from the Hospital Ethics Committee, a total of 50 cases of metabolic syndrome presenting as outpatient or inpatient were included in the study. 50 age &amp; sex matched controls were selected which did not satisfy the criteria for metabolic syndrome. Observation &amp; Results: In our study we found that the cases with metabolic syndrome have significantly increased levels of Fibrinogen, Factor VIII and Plasminogen Activator Inhibitor1 (PAI1). PT &amp; APTT were shorter in cases with metabolic syndrome. The mean value of fibrinogen in cases was 402.24 ± 66.92 mg/dl while that in control was 261.5 ± 41.95 mg/dl with a P value of &lt;.0001 which was statistically significant. The mean value of Factor VIII in cases was 152.66 ± 7.54 IU/dl while that in control was 131.44 ± 6.24 IU/dl with a P value of &lt;.0001 which was statistically significant. The mean value of Plasminogen Activator Inhibitor1 (PAI1) in cases was 49.99 ± 5.34 ng/ml while that in control was 36.75 ± 3.35 ng/ml with a P value of &lt;.0001 which was statistically significant. Prothrombin Time (PT) values in cases were 9.79 ± 0.74 seconds and in controls were 12.04 ± 0.7 seconds &amp; this difference was statistically significant (p&lt;.0001). Activated partial Thromboplastin Time (APTT) values in cases were 28.96 ± 0.92 seconds and in controls were 32.6 ± 1.34 seconds &amp; this difference was statistically significant (p&lt;.0001). Conclusions: The coagulation parameters studied correlated significantly with the components of metabolic syndrome. The values varied significantly with increased number of features of metabolic syndrome. Thus we can conclude that metabolic syndrome is a hypercoagulable state and further studies are required for further evaluation of the consequences of this hypercoagulable state.. Disclosures No relevant conflicts of interest to declare.

Could fibrinogen and hsCRP be useful for assessing personal risk in workers exposed to a mixture of ultrafine particles and organic solvents?

Abstract Purpose: Our study focuses on elucidating if two common inflammatory biomarkers, easily performed in any laboratory - high-sensitivity C-reactive protein (hsCRP), as well as fibrinogen - could be used to assess the personal health risk of workers exposed to a complex occupational exposure to ultrafine particles (UFP) and a mixture of organic solvents. Methods: To assess the inflammatory response on the body, laboratory determinations were performed by testing the serum levels of hsCRP and fibrinogen, in exposed and unexposed groups. Results: There are no statistically significant differences for hsCRPs (p-0.25), medians were similar in groups. The mean values of fibrinogen in the three groups were: in the workers group (1st group): 346.2 mg/dl, in the office staff group (2nd group): 328.7 mg/dl, and in the control group (3rd group): 284.8 mg/dl, with significant differences between 1st group vs 3rd group and between 2nd group vs 3rd group (p-0.002). UFP levels differ between the groups, as follows: 1st group were exposed to the highest levels, ranging from 48349 to 3404000 part/cm3; 2nd group, ranging from 17371 to 40595 part/cm3; and 3rd group, ranging from 213 to 16255 part/cm3. Conclusions: Our study demonstrates that fibrinogen is a useful inflammatory biomarker for exposure to a mixture of UFP and organic solvents. On the other hand, hsCRP is not a useful inflammatory biomarker in occupational exposure to UFP and organic solvents. Further studies are needed to demonstrate the extent to which fibrinogen is more or less influenced by organic solvents or UFP alone.

A Study of Prognostic Value of Hs-CRP and Fibrinogen in Patients of Unstable Angina

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Unstable angina constitutes a clinical syndrome that is usually caused by atherosclerotic coronary artery disease and is associated with an increased risk of cardiac death and myocardial infarction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and Methods:&lt;/strong&gt; An open, prospective, observational, comparative study was conducted. The study included 50 cases in age group 20-80 years admitted in Government Medical College, Amritsar diagnosed as unstable angina ruled out by Trop T and CPK-MB at admission. Hs-CRP and Fibrinogen levels were estimated at time of admission and repeated after 48 hours.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; There was significant difference in the mean value of Hs-CRP between favourable and unfavourable group at the time of admission (0.807±0.37mg/l v/s 3.57±1.70mg/l, p&amp;lt;0.001). A significant difference in the mean value of Hs-CRP was found between favourable and unfavourable group after 48 hours (0.51±0.22mg/l v/s 4.03±1.84mg/l, p&amp;lt;0.001) There was significant difference in the mean value of fibrinogen between favourable and unfavourable group at the time of admission (356.94±72.50mg/dl v/s 588.60±94.89mg/dl, p&amp;lt;0.001). A significant difference in the mean value of fibrinogen was found between favourable and unfavourable group after 48 hours (309.11±75.25mg/dl v/s 622.60±133.42mg/dl, p&amp;lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; It is concluded that in patients with unstable angina, elevated levels of Hs-CRP and Fibrinogen at admission indicate an adverse hospital outcome.&lt;/p&gt;

Cigarette smoking is associated with dose-dependent adverse effects on paraoxonase activity and fibrinogen in young women

Context: Smoking is associated with increased fibrinogen and decreased paraoxonase (PON) activity, markers of inflammation and oxidative stress, in patients with coronary artery disease.Objective: We tested the hypothesis that the adverse effect of smoking on these biomarkers of inflammation and oxidative stress would be detectable in otherwise healthy young female habitual smokers.Materials and methods: Thirty-eight young women participated in the study (n = 20 habitual smokers, n = 18 non-smokers). Fibrinogen, PON-1 activity and HDL oxidant index (HOI) were measured.Results: Mean values of fibrinogen, PON-1 activity and log HOI were not different between the groups. Importantly, however, decreased PON-1 activity (rs = −0.51, p = 0.03) and increased fibrinogen (rs = 0.49, p = 0.04) were significantly correlated with increasing number of cigarettes smoked per day in habitual smokers.Discussion and conclusion: Cigarette smoking is associated with a dose-dependent adverse effect on PON-1 activity and fibrinogen in young women, which may have implications for future cardiovascular risk.

ADAMTS-13 contents in therapeutic plasma products

Background ADAMTS-13 is a zinc-containing metalloprotease enzyme that cleaves the von Willebrand factor (VWF). In human beings, changes in ADAMTS-13 levels have been observed in a number of diseases. The determination of ADAMTS-13 levels and those of its substrate will help to elucidate therapeutic strategies including ADAMTS-13 supplementation for these diseases. Successful treatment has been reported with both fresh-frozen plasma and cryoprecipitate poor plasma (CPP) as replacement fluids. This study aimed to investigate ADAMTS-13 and some coagulation factors in the different plasma products commonly used to increase ADAMTS-13 levels. Materials and methods A total of 180 U of whole blood (WB) were collected from healthy young male blood donors, their ages ranging from 20 to 32 years. Sixty donors were of blood type O+, 50 were A+, 50 were B+, and 20 were AB+. All blood donors included in this study underwent tests for assessment of their liver and kidney functions, and they were declared free from any disease. Plasma from the blood samples was extracted either on the day of collection (the platelet-rich plasma method) or after an overnight hold of WB (the Buffy coat method). Factor VIII (FVIII) activity was measured and levels of fibrinogen, VWF, and human ADAMTS-13 in plasma were quantitatively determined. Results There was no difference in the mean concentrations of ADAMTS-13 in plasma products obtained using the two different methods. Blood group O showed a higher concentration compared with other ABO blood groups. The concentration of ADAMTS-13 was higher in cryoprecipitate than in plasma and CPP. The mean values of FVIII activity were lower in many plasma and cryoprecipitate units prepared by overnight holding of WB for close to 24 h. In addition, the mean values of FVIII activities and VWF levels were lower in plasma and cryoprecipitate units prepared from blood group O compared with those prepared from other ABO blood groups. No differences were detected in the mean values of fibrinogen and VWF in the plasma products when different methods were used for preparation. Conclusion The observation that the concentration of ADAMTS-13 is higher in cryoprecipitate than in plasma and CPP suggests that cryoprecipitate may be a reasonable source of ADAMTS-13 in clinical settings when volume is an issue. In addition, in our study, the use of cryoprecipitate from blood group O in clinical settings yielded higher concentrations of ADAMTS-13 with less VWF. Although the use of cryoprecipitate instead of plasma or CPP could potentially double the amount of ADAMTS-13 infused, further studies from multiple centers are needed to validate the results.

Incresed inflammatory response in patients with the first myocardial infarction and nonsignificant stenosis of infarct-related artery

Atherosclerosis presents a serial of highly specific cellular and molecular responses, and could be described as inflammatory diseases. Accordingly, for development of acute myocardial infarction (AMI), structure and vulnerability of atherosclerotic plaque are more important than the extent of stenosis of infarct-related artery. Consequently, inflammation and atherosclerosis and its complications are in good correlation. C-reactive protein (CRP) as nonspecific inflammatory marker, has prognostic significance in coronary artery diseases. The aim of this study was to establish the correlation between inflammatory response expressed as levels of CRP and fibrinogen in serum and extent of coronary artery stenosis. Study included 35 patients with acute myocardial infarction, as the first manifestation of coronary artery disease, which were treated with thrombolytic therapy according to the guidelines. All the patient had a reperfusion. The patients with acute or chronic inflammatory diseases, an increased value of sedimentation, fibrinogen, CK > or = 190 U/L, early and late complications of AMI were excluded. CRP was measured on admission, after 24, 48 and 72 hrs, and 21 days latter, while fibriogen only on admission. All the patients underwent coronary angiography, and were divided into two groups: the group 1 (23 patients), with significant stenosis of infarct-related artery (stenosis > or = 75%), and the group 2 (13 patients) without significant stenosis (< 75%). Mean value of CRP serum level on admission in the group 1 was 4.4 mg/L, and in the group 2 7.2 mg/L (p < 0.001). The mean value of fibrinogen on admission in the group 1 was 2.7 g/L, and in the group 2 3.0 g/L (p < 0.001). The mean CRP value after 48 hrs in the group 1 was 21.7 mg/L, and in the group 2 42.4 mg/L. (p < 0.001). After three weeks, the mean CRP value was 4 mg/L in the group 1 and 5.5 mg/L in the group 2 (p < 0.001). There was no significant difference between the groups 1 and 2 related to gender, age, localization of AMI, CK, EF value, and risk factors for coronary artery disease. The patients with nonsignificant stenosis of infarct-related artery had increased inflammtory responses according to the CRP value, as a result of inflammatory process in atherosclerotic plaque and/or enhanced individual reactivity.

Androgenetic alopecia and cardiovascular risk factors in men and women: A comparative study

Numerous studies in recent decades have associated male androgenetic alopecia (AGA) with the risk of cardiovascular disease. However, only 3 studies have addressed this association in female patients. Most studies considered the risk of myocardial infarction or mortality as a result of heart disease, without analyzing cardiovascular risk factors. The objectives of this study were to analyze the presence of cardiovascular risk factors included in the Adult Treatment Panel-III criteria for metabolic syndrome, the prevalence of carotid atheromatosis, hormonal (aldosterone, insulin, testosterone, and sex hormone-binding globulin) factors, and acute phase reactant (C-reactive protein, fibrinogen, D-dimers, erythrocyte sedimentation rate) variables in male and female patients with AGA and in a control group, and to analyze differences among the groups. This case-control study included 154 participants, 77 with early-onset AGA (40 male and 37 female) and 77 healthy control subjects (40 male and 37 female) from the dermatology department at a university hospital in Granada, Spain. Metabolic syndrome was diagnosed in 60% of male patients with AGA (odds ratio [OR] = 10.5, 95% confidence interval [CI] 3.3-32.5), 48.6% of female patients with AGA (OR = 10.73, 95% CI 2.7-41.2), 12.5% of male control subjects, and 8.1% of female control subjects (P < .0001). Atheromatous plaques were observed in 32.5% of male patients with AGA (OR = 5.93, 95% CI 1.5-22.9) versus 7.5% of male control subjects (P = .005) and 27% of female patients with AGA (OR = 4.19, 95% CI 1.05-16.7) versus 8.1% of female control subjects (P = .032). Aldosterone and insulin levels were significantly higher in the male and female patients with AGA versus their respective control subjects. Mean values of fibrinogen were significantly higher in male patients with AGA, whereas values of fibrogen, C-reactive protein, and D-dimers were significantly higher in female patients with AGA versus their respective control subjects. The study of a wider sample of patients with AGA would confirm these findings and allow a detailed analysis of the above factors as a function of the degree of alopecia or between menopausal and premenopausal women. The determination of metabolic syndrome and ultrasound study of the carotid arteries may be useful screening methods to detect risk of developing cardiovascular disease in male and female patients with early-onset AGA and signal a potential opportunity for early preventive treatment.

Clinical significance of a high ankle-brachial index: Insights from the Atherosclerosis Risk in Communities (ARIC) Study

Background The clinical significance of a high ankle-brachial index (ABI), defined by the associated risk factor burden and ischemic risk, is largely unknown. Methods Using data from the Atherosclerosis Risk in Communities Study, we categorized 14,777 participants into normal (ABI between 0.9 and 1.3) and high ABI groups (ABI > 1.3, >1.4, and >1.5) and compared the risk factor profile and CVD event rates of the normal ABI group to each high ABI group. Results The prevalence of high ABI was 5.5% for ABI > 1.3, 1.2% for ABI > 1.4, and 0.37% for ABI > 1.5. Compared with participants with a normal ABI, those with ABI > 1.3 had a lower prevalence of hypertension and current smoking. The ABI > 1.3 group had a greater mean body mass index, but was characterized by fewer pack years of smoking and lower systolic and diastolic blood pressures than the normal ABI group. The prevalence of diabetes, left ventricular hypertrophy, claudication, and coronary heart disease and mean values of fibrinogen, factor VIII activity, von Willebrand factor, lipoprotein (a), and carotid and popliteal intimal-medial thickness were similar between the two ABI groups. The risk factor profiles of the ABI > 1.4 and >1.5 groups were also not statistically significantly different from that of the normal ABI group. Over a mean follow-up time of 12.2 years, the age, sex, and race-adjusted CVD event rates per 1000 person years were 8.1 in the normal ABI group, 7.6 in the ABI > 1.3 group, 7.6 in the ABI > 1.4 group, and 7.4 in the ABI > 1.5 group. The CVD event rates of the high ABI groups were similar to that of the normal ABI group. Conclusion Individuals with a high ABI are not characterized by a more adverse atherosclerosis risk factor profile and do not suffer greater CVD event rates than those with a normal ABI.

Stressful Life Events and Fibrinogen Level in Middle-Aged Teachers

Background: Strong evidence has been reported that a high plasmatic level of fibrinogen plays a central role in the development of coronary heart disease. Many researches showed that stressful life events lead to an increase in plasmatic fibrinogen. The present investigation examined the relationship between plasmatic fibrinogen level and stressful life events. Sampling and Methods: A sample of 40 middle-aged women employed as teachers underwent a general objective examination, a venous puncture for plasma fibrinogen level evaluation, and completed a questionnaire regarding health behaviours, at baseline and 1-year follow-up. The stressful life events were recorded using the Paykel’s interview for recent life events. Results: At the baseline assessment, the distribution of teachers in the two stress exposure groups was 16 women for the non-exposed group of teachers, and 24 for the exposed teachers, while at the 1-year follow-up assessment, it was 10 for the non-exposed and 30 for the exposed group. The number of teachers exposed to stress was significantly higher at the 1-year follow-up than at the baseline assessment (30 and 24, respectively; p < 0.05). Average levels of plasmatic fibrinogen were significantly higher in stress-exposed women than in non-exposed women both at baseline assessment (p < 0.01) and at 1-year follow-up (p < 0.002). Moreover, the mean value of fibrinogen at the follow-up assessment showed a higher increase in stressed women compared with non-stressed women with an annual increase of 10.71 and 5.40%, respectively. Conclusions: Stress may trigger the hypercoagulable state evidenced by an increased plasmatic fibrinogen level. This mechanism may help explain the adverse impact of stress on the cardiovascular system.

The use of single-donor fibrin glue prepared by recycled cryoprecipitation in experimental liver surgery.

The purpose of the study was to evaluate the hemostatic effectiveness of fibrin glue (FG) prepared by a modification of cryoprecipitation technique in experimental rat liver surgery. FG component 1 was prepared by triple or 'recycled' cryoprecipitation method from single-donor plasma. Rats subjected to liver incision, partial and total lobectomy were treated with FG on the surgical cut surface or underwent standard surgical technique. The efficacy of FG-treatment was evaluated on the basis of the 24-hour survival ratio and peripheral blood hematological parameters. The mean values of fibrinogen, FXIII, fibronectin and horizontal tensile strength of FG were 54.2 +/- 19.9 g/l, 13.5 +/- 3.6 IU/ml, 3103.1 +/- 148.9 mg/l, and 1.076 +/- 0.18 N/cm2, respectively. The survival of FG-treated rats subjected to partial and total lobectomy was significantly higher in comparison to the FG-nontreated animals, accompanied with higher values of red blood cell counts, hemoglobin concentration and hematocrit. When liver incision was performed, although there were no differences in survival rate, FG-treated animals had significantly higher values of the tested hematological parameters. The presented results demonstrated that by using 'recycled' cryoprecipitation it is possible to obtain high quality single-donor FG with successful hemostatic therapeutical effects, as confirmed in the experimental rat model of liver surgery.

Plasma fibrinogen and coronary heart disease in urban Japanese.

There is little information on the relation of plasma fibrinogen concentration to the risk of coronary heart disease in Asians, including Japanese, whose plasma fibrinogen concentration has been reported to be low by Western standards. The authors conducted a prospective study with 4.8 years of follow-up of 11,977 men and women aged 21-89 years (mean value of fibrinogen = 267 mg/dl) living or working in Osaka, Japan, in 1990-1996 to examine the relation of plasma fibrinogen with the incidence of coronary heart disease (myocardial infarction and angina pectoris). Mean fibrinogen concentration was 293.6 mg/dl for men who developed coronary heart disease (n = 35) compared with 261.6 mg/dl for men free of coronary heart disease (n = 8,094; difference, p < 0.01), and 355.2 mg/dl for women who developed coronary heart disease (n = 6) compared with 276.8 mg/dl for women free of coronary heart disease (n = 3,842; difference, p < 0.01). With a Cox proportional hazards model to adjust for cardiovascular risk factors, the relative risk for the highest fibrinogen quartile (> or =295 mg/dl) compared with the lowest (<228 mg/dl) was 4.8 (95% confidence interval: 1.4, 16.8, p = 0.01) for coronary heart disease, and 3.8 (95% confidence interval: 1.1, 13.4, p = 0.04) for myocardial infarction. Plasma fibrinogen is useful to predict the risk of coronary heart disease among urban Japanese, whose mean plasma fibrinogen is relatively low.

Evaluation of fibrin glue prepared by recycled cryoprecipitation in experimental liver surgery

Fibrin glue (FG) is a two component biologic system with adhesive, sealant and topical hemostatic properties, containing fibrinogen, factor XIII, fibronectin, thrombin, some antifibrinolytic agent and ionized calcium. The purpose of the study was to evaluate the hemostatic effectiveness of FG prepared by a modification of cryoprecipitation technique in experimental rat liver surgery. FG component 1 was prepared by triple or “recycled” cryoprecipitation method from single-donor plasma. Rats subjected to liver incision, partial and total lobectomy were treated with FG on the surgical cut surface or underwent standard surgical technique and the efficacy of the FG-treatment was evaluated on the basis of the 24-hour survival ratio and peripheral blood hematological parameters. The mean values of fibrinogen, FXIII, fibronectin and horizontal tensile strength of FG were 54.2 ± 19.9 g/l, 8.03 ± 2.3 IU/ml, 3103.1 ± 148.9 mg/l, and 1.076 ± 0.18 N/cm2, respectively. The survival of FG-treated rats subjected to partial and total lobectomy was significantly higher in comparison to the FG-nontreated animals, accompanied with higher values of red blood cell counts, hemoglobin concentration, as well as hematocrit. The survival of animals subjected to liver incision was not significantly different, however the differences in hematological parameters were significant in favor FG-treated animals. The presented results demonstrated that using “recycled” cryoprecipitation it is possible to obtain high quality single-donor FG with successful hemostatic therapeutical effects, as confirmed in the experimental rat liver surgery.

Hormone Replacement Therapy and Circulating ICAM-1 in Postmenopausal Women

Hormone replacement therapy may reduce the risk of coronary heart disease but underlying mechanism has not been adequately explained. Recent data suggest that intercellular adhesion molecule 1 (ICAM-1) plays a critical role in early stage of atherosclerosis and may serve as a molecular marker for the development of arterial disease. We investigated the effects of oral and transdermal cyclic oestradiol combined with progesterone on plasma concentration of soluble ICAM-1 (sICAM-1). Thirty-seven healthy postmenopausal women were randomly assigned to receive either oral estradiol valerate or transdermal estradiol both combined with micronized progesterone or no hormonal treatment. Plasma sICAM-1 was assayed at baseline and after a 6-month period. Oral but not transdermal estradiol regimen significantly decreased mean value of sICAM-1 compared with no treatment. Differences in sICAM-1 levels between active treatments were significant. There were no significant changes in mean values of fibrinogen between the three groups. Our results show a favorable effect of oral estrogen plus progesterone on a soluble marker of vascular inflammation and may provide plausible explanation for a cardioprotective effect of hormone replacement therapy among healthy postmenopausal women.

Elevated Plasma Fibrinogen and Increased Fibrin Turnover among Healthy Women who both Smoke and Use Low-dose Oral Contraceptives

Among users of low-dose oral contraceptives (OC), cardiovascular diseases occur mainly in smokers. The mechanisms by which OC and smoking increase the risk for arterial thrombotic risk have not been adequately explained. Epidemiological evidence suggests that changes in blood coagulation and fibrinolysis may play an important role as determinants of thrombotic events. Therefore, we have investigated the associations of OC and smoking with haemostatic variables among 194 premenopausal healthy women. Fourty women were current users of low-dose OC and 62 women were smokers. After adjustment for age and body mass index, mean values of factor XIIa, factor VII activity and antigen, fibrinogen, D-dimer, global fibrinolytic capacity were significantly higher in OC users than in non-users. Mean levels of PAI activity and t-PA antigen were significantly lower in OC users than in non-users. Smokers had significantly higher mean values of fibrinogen than non-smokers. Two-way analysis of variance showed that the differences in mean levels of fibrinogen and D-dimer between OC users and non users were restricted to smokers. The positive and significant interactions between OC use and smoking in their effects on haemostatic variables were consistent with respect to age and type of OC. These preliminary data suggest that elevated plasma levels of fibrinogen and intravascular fibrin deposition may play a role in the pathogenesis of arterial thrombotic disease among women who are both low-dose OC users and smokers.

Curvilinear Relations between Age and Hemostatic Parameters in Chinese

The role of hemostatic factors in the pathogenesis of cardiovascular disease has gained much attention recently. Information about hemostatic factors, and their age patterns is sparse for orientals. With the data collected in the Cardiovascular Disease Risk Factor Two-township Study in Taiwan, this study shows that, in general, the older the age, the stronger the tendency toward thrombosis. With advancing age, prothrombin time, activated partial thromboplastin time, and antithrombin-III level decreased steadily; but mean values of fibrinogen, factor VIIc, and factor VIIIc increased. Gender differences in the age patterns of the above factors are carefully described. Curvilinear relations between hemostatic factors and age were demonstrated for adults aged 18 and above for all hemostatic factors studied. This curvilinearity should be taken into consideration when adjusting for the effect of age in data analysis to avoid residual confounding, particularly when the age range of the study subjects is wide.

Comparative Studies of Blood Coagulation and Platelet Aggregation in Patients with Cancer and Nonmalignant Diseases

Blood coagulation and platelet function was evaluated in 106 hospitalized patients with cancer and compared with 40 patients with nonmalignant diseases and 50 normal subjects. The mean value of the prothrombin time was prolonged in patients both with and without cancer. The activated partial thromboplastin time was accelerated in both groups of patients. The mean values of fibrinogen, cryofibrinogen, factor VIII, and factor V were similarly elevated in patients with and without cancer. Changes of optical density during adenosine diphosphate ( ADP )-induced platelet aggregation as well as aggregation of platelets in the Chandler system were comparable in both groups of patients. Elevation of platelet counts and positive tests for fibrinolytic split products were observed only in patients with cancer. Coagulation abnormalities were observed in many patients who had no clinical evidence of thromboembolism or disseminated intravascular coagulation. The simultaneous elevation of several clotting factors, together with evidence of abnormal platelet aggregation and the presence of fibrinolytic split products, may have value for predicting impending intravascular coagulation in patients with cancer.