[Prothrombotic state in early stages of chronic Chagas' disease. Its association with thrombotic risk factors].

OBJECTIVE: The aim of this study was to explore the presence of prothrombotic state in early stages of chronic Chagas' disease with serum markers of thrombosis and fibrinolysis, and to investigate it's association with thrombotic risk factors for venous thromboembolic disease. PATIENTS AND METHODS: Forty two patients with chronic Chagas' disease were compared with 21 healthy volunteers. Thrombotic markers used were fragment 1 + 2, ATM complex, fibrinogen/fibrin degradation products, D-dimer and beta-thromboglobulin. Fibrinolysis was evaluated with euglobulin lysis time, tissue plasminogen activator and it's inhibitor levels. A thrombophilic screening was performed. Antithrombin and protein C were determined by functional methods, as well as free fraction of protein S, resistance to activated protein C, factor V Leiden R506Q mutation, prothrombin G20210A mutation, homocysteine and antiphospholipid antibodies: lupus and anticardiolipin antibodies isoforms IgG and IgM.
RESULTS: In chronic Chagas' disease patients, statistically significant differences were observed in thrombotic markers: fragment 1 + 2 (p < 0.0001), ATM complex (p < 0.0001), fibrinogen/fibrin degradation products (p < 0.05) and D-dimer (p < 0.05). beta-thromboglobulin did not reach statistically significant difference (p = 0.06). Statistically significant differences (p < 0.0001) were found only in euglobulin lysis time, a non specific fibrinolytic marker. Specific fibrinolytic markers tissue plasminogen activator and it's inhibitor, however, did not show statistically significant differences among studied groups.
CONCLUSIONS: Eighty six percent of patients had positive thrombophilic screening for at least one thrombophilic risk factor. Thrombophilic risk factors were inherited in 39% and acquired in 83% of the patients.