ENHANCED SOLUBLE THROMBOMODULIN, T-PA AND U-PA CONCENTRATIONS CAUSED BY SHORT-TERM ENDOTHELIAL DAMAGE DURING PERCUTANEOUS CARDIAC-CATHETERIZATION

Objective: circulating plasma thrombomodulin (TM), tissue-type plasmin ogen activator (t-PA) and urokinase-type plasminogen activator (u-PA) are endothelial cell markers which may reflect endothelial injury. To find out io what extent diagnostic cardiac percutaneous catheterisatio n irritates vascular endothelium we conducted a prospective study in 1 14 children. Results: compared to starting values TM, t-PA and u-PA co ncentrations show a clearly significant increase at the end of cardiac catheterisation. TM and u-PA returned to pretreatment values 24 hours later, t-PA remained elevated. Four of 114 children developed vascula r occlusion near the puncture sites within 48 hours of cardiac cathete risation. Two patients < 1 year of age showed resistance to APC, one c hild with recurrent thromboembolism showed familiar thrombophilia with elevated lipoprotein (a) levels. Conclusions: data of this study indi cate that increased TM, t-PA and u-PA concentrations after percutaneou s cardiac catheterisation in children are signs of endothelial damage.