Poor fibrinolytic response to venous occlusion by different criteria in patients with deep vein thrombosis

• Published in: Thrombosis research Vol. 64; no. 4; pp. 445 - 453
• Main Authors: Stegnar, Mojca, Peternel, Polona, Keber, Dušan, Vene, Nina
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Ltd 15.11.1991; Elsevier Science
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - analysis; Body Mass Index; Cardiology. Vascular system; Constriction; deep vein thrombosis; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fibrinolysis; Humans; Male; Medical sciences; Middle Aged; Plasminogen Inactivators - analysis; Recurrence; Risk Factors; Thrombophlebitis - blood; Thrombophlebitis - physiopathology; Tissue Plasminogen Activator - analysis; venous occlusion; fibrinolysis; deep vein thrombosis; venous occlusion; Human; Deep vein thrombosis; Cardiovascular disease; Fibrinolysis
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/0049-3848(91)90345-W

Five criteria for poor response to a 20 min venous occlusion test were applied to 58 patients 3 months or more after acute deep vein thrombosis (DVT). The criteria were arbitrarily defined as the last 5 percentiles of response distributions in an age- and sex-matched healthy control group of 51 subjects. The criteria were: 1. euglobulin clot lysis time after venous occlusion ≥ 140 min; 2. t-PA activity after venous occlusion ≤ 0.04 IU/ml; 3. increase in t-PA antigen above resting value ≤ 2-fold; 4. ratio between t-PA antigen increase and resting PAI activity ≤ 0.5 ng/IU; 5. PAI activity after venous occlusion ≥ 6 IU/ml. The last criterion of poor response was the only one that was significantly more frequently reached by patients than by controls: 28% (p<0.005) of all DVT patients and 35% (p<0.005) of the subgroup with idiopathic DVT (N=34) were found to be poor responders. The percentage of poor responders according to the other four criteria was 7–11% in all patients and 9–15% in the subgroup with idiopathic DVT and thus was not significantly higher than in controls (5% by definition). It was concluded that residual PAI activity after venous occlusion might be a useful criterion for prospective studies on recurrence of DVT.