Level of antithrombin III, protein C, protein S and other selected parameters of coagulation and fibrinolysis in the blood of the patients with recurrent deep venous thrombosis.

BACKGROUND: Thrombophilia is caused mainly by disturbances of hemostasis involving excessive coagulation system activation, reduction of anticoagulation system (antithrombin III, protein C, protein S, RAPC) or fibrinolytic activity. MATERIAL/
METHODS: In 34 young patients (aged <40 years) with recurrent deep venous thrombosis (>2 incidents) the activity of antithrombin III, protein C, S, platelet count, adhesion and aggregation, APTT, stipven-kephalin, prothrombin time and INR were investigated. Fibrinogen, factor XIII, ELT, FDP, Ag t-PA levels, antigen concentration and PAI-1 activity were determined. Patients with idiopathic DVT, after elimination of most important thromboembolism risk factors, were qualified for the study. DVT was confirmed in all patients by phlebography, plethysmography and ultrasonography. Results were compared with a group of 54 healthy controls.
RESULTS: In almost 50% of patients with recurrent DVT (15/34) decrease of at least one plasma coagulation inhibitor (AT III, PC, PS) level was observed. In the patient group (with AT III and/or PC and/or PS decrease) statistically significant reduction of kaolin-kephalin time in comparison with controls was observed (a<0. 01). Analysis of fibrinolysis system demonstrated significant factor XIII level decrease (to 58.3%), fibrinogen level increase, ELT prolongation, and fibrinogen and fibrin degradation product increase in comparison with controls. The patients demonstrated 3-fold higher t-PA antigen level (13.1 ng/ml, a<0. 0001) and over 3-fold higher PAI-1 activity (26.7 AU/ml, a<0. 001) than healthy controls.
CONCLUSIONS: Reduced antithrombin III, protein C, protein S activity and excessive activation of the coagulation system with secondary fibrinolytic activity increase were found in patients with recurrent DVT.