Markers of hemostatic system activation in pulmonary embolism. Changes during and after cessation of anticoagulant treatment

Plasma levels of prothrombin fragment 1+2 (F1+2), thrombin-antithrombin com plexes (TAT) and D-dimers were measured in 15 patients with pulmonary embol ism during heparin therapy, oral anticoagulation, and after cessation of wa rfarin therapy. Each patient had a favorable outcome during anticoagulant t herapy (3 months), but late venous thromboembolism occurred in six cases. T he mean levels of the three markers were significantly increased on day 4 a fter the thrombotic event, and normalized during warfarin therapy. Nine mon ths after the initial pulmonary embolism, mean levels of the three markers, as compared with a control population, were significantly higher in the pa tients with late recurrences, whereas only TAT were slightly higher in pati ents without recurrences as compared with controls. Only TAT levels were si gnificantly higher in the patients with late recurrences than in those with out late recurrences. Thus, the levels of the three markers 9 months after pulmonary embolism seem to be interesting to identify patients with high ri sk of recurrence and who might require longer anticoagulant treatment. Bloo d Coagul Fibrinolysis 11:249-253 (C) 2000 Lippincott Williams & Wilkins.