Measurement of prethrombotic markers in the assessment of acquired hypercoagulable states

Hypercoagulable states can be detected by measuring activation peptides, en zyme-inhibitor complexes, and fibrin/fibrinogen degradation products, which are markers of hemostatic activation. A series of these prethrombotic mark ers has been evaluated in the elderly, pregnancy, diabetes and acute myocar dial infarction patients (n=30 in each group) as well as in hematologic mal ignancies (n=42). The parameters assayed were: prothrombin fragment 1+2(F12), thrombin-antithrombin III complexes (TAT), fibrinopeptide A (FPA), plas min-alpha(2) antiplasmin complexes (PAP) and D-Dimer. Results were compared with those obtained in a group of 30 healthy subjects. We found a significant increase of F1+2, TAT and FPA in elderly (p<0.05), a cute myocardial infarction (AMI) (p<0.01), hematologic malignancies (p<0.01 ), and pregnancy (p<0.0001), indicating a marked clotting activation. Diabe tic patients under strict metabolic control only presented a moderate incre ase of TAT (p<0.05), suggesting a slight activation. We also observed a hig hly significant elevation of PAP and D-Dimer in elderly (p<0.001), AMI (p<0 .0001), and malignancy (p<0.0001), indicating an activation of the fibrinol ytic system. The combination of selected fibrinolytic and coagulation measu rements is useful for the detection of a hypercoagulable state in condition s characterized by a risk of thrombosis. (C) 1999 Elsevier Science Ltd. All rights reserved.