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Article: Baseline plasma fibrinolysis and its correlation with clinical manifestations in patients with Raynaud's phenomenon

TitleBaseline plasma fibrinolysis and its correlation with clinical manifestations in patients with Raynaud's phenomenon
Authors
Issue Date1993
PublisherB M J Publishing Group. The Journal's web site is located at http://ard.bmjjournals.com/
Citation
Annals Of The Rheumatic Diseases, 1993, v. 52 n. 6, p. 443-448 How to Cite?
AbstractObjectives - (1) To assess if patients with various forms of Raynaud's phenomenon (RP) have abnormal plasma fibrinolysis that may contribute to diminished digital blood flow; (2) to assess whether patients with RP with evidence of endothelial damage have abnormal plasma fibrinolysis; (3) to determine the clinical relevance of abnormalities, if any, in plasma fibrinolysis in patients with RP. Methods - One hundred and sixty eight patients with significant RP were studied - 46 had primary Raynaud's disease (RD), 32 had suspected Raynaud's syndrome secondary to an undifferentiated connective tissue disorder (undifferentiated CTD), 25 had Raynaud's syndrome associated with atherosclerosis (athero RS), and 65 had an underlying connective tissue disease (CTD RS). All attended in the morning after a low fat light breakfast. After a clinical history was obtained, venous blood samples were collected without stasis for assays of plasma fibrinolysis and factor VIII von Willebrand factor antigen (fVIII vWF Ag). Results were compared with those obtained from normal subjects matched for sex and age. As patients with athero RS were significantly older than the other patients with Raynaud's phenomenon, two groups of control subjects were recruited-namely, 'old' and 'young' control subjects. Results - Patients with CTD RS and athero RS had higher concentrations of fVIII vWF Ag (CTD RS median 174.5 range (45-370)% v 100 (38-202)%, p<0.001; athero RS 182.5 (100-240)% v 100 (50-158)%, p<0.001). Both had raised fibrinogen (CTD RS 3.25 (1.9-6.8) g/l v 2.4 (1.2-4.2) g/l, p<0.001; athero RS 3.4 (2.2-6.2) g/l v 2.5 (1.8-3.9) g/l, p<0.001) and both had diminished fibrinolysis with reduced plasminogen activator activity (CTD RS 79.5 (31-72) mm2 v 92 (37-197) mm2, p<0.04; athero RS 73 (45-125) mm2 v 98 (41-197) mm2, p<0.03). Patients with CTD RS also had raised plasminogen activity (3.3 (2.3-5.8) cU/ml v 2.9 (1.5-5.4) cU/ml, p<0.001). On the contrary, patients with primary RD and undifferentiated CTD had normal fibrinogen and plasma fibrinolysis. Within each patient group, no significant differences in any of the measured variables were found between those who had RP all year and those who had RP in the winter only, those with RP of the hands only and of hands and feet, or those with and without digital ulcers. Conclusion - Diminished plasma fibrinolysis is found in patients likely to have endothelial damage (CTD RS and athero RS). These changes are probably a consequence rather than a cause of the disease.
Persistent Identifierhttp://hdl.handle.net/10722/161984
ISSN
2015 Impact Factor: 12.384
2015 SCImago Journal Rankings: 4.537
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLau, CSen_US
dc.contributor.authorMclaren, Men_US
dc.contributor.authorMackay, Ien_US
dc.contributor.authorBelch, JJFen_US
dc.date.accessioned2012-09-05T05:16:28Z-
dc.date.available2012-09-05T05:16:28Z-
dc.date.issued1993en_US
dc.identifier.citationAnnals Of The Rheumatic Diseases, 1993, v. 52 n. 6, p. 443-448en_US
dc.identifier.issn0003-4967en_US
dc.identifier.urihttp://hdl.handle.net/10722/161984-
dc.description.abstractObjectives - (1) To assess if patients with various forms of Raynaud's phenomenon (RP) have abnormal plasma fibrinolysis that may contribute to diminished digital blood flow; (2) to assess whether patients with RP with evidence of endothelial damage have abnormal plasma fibrinolysis; (3) to determine the clinical relevance of abnormalities, if any, in plasma fibrinolysis in patients with RP. Methods - One hundred and sixty eight patients with significant RP were studied - 46 had primary Raynaud's disease (RD), 32 had suspected Raynaud's syndrome secondary to an undifferentiated connective tissue disorder (undifferentiated CTD), 25 had Raynaud's syndrome associated with atherosclerosis (athero RS), and 65 had an underlying connective tissue disease (CTD RS). All attended in the morning after a low fat light breakfast. After a clinical history was obtained, venous blood samples were collected without stasis for assays of plasma fibrinolysis and factor VIII von Willebrand factor antigen (fVIII vWF Ag). Results were compared with those obtained from normal subjects matched for sex and age. As patients with athero RS were significantly older than the other patients with Raynaud's phenomenon, two groups of control subjects were recruited-namely, 'old' and 'young' control subjects. Results - Patients with CTD RS and athero RS had higher concentrations of fVIII vWF Ag (CTD RS median 174.5 range (45-370)% v 100 (38-202)%, p<0.001; athero RS 182.5 (100-240)% v 100 (50-158)%, p<0.001). Both had raised fibrinogen (CTD RS 3.25 (1.9-6.8) g/l v 2.4 (1.2-4.2) g/l, p<0.001; athero RS 3.4 (2.2-6.2) g/l v 2.5 (1.8-3.9) g/l, p<0.001) and both had diminished fibrinolysis with reduced plasminogen activator activity (CTD RS 79.5 (31-72) mm2 v 92 (37-197) mm2, p<0.04; athero RS 73 (45-125) mm2 v 98 (41-197) mm2, p<0.03). Patients with CTD RS also had raised plasminogen activity (3.3 (2.3-5.8) cU/ml v 2.9 (1.5-5.4) cU/ml, p<0.001). On the contrary, patients with primary RD and undifferentiated CTD had normal fibrinogen and plasma fibrinolysis. Within each patient group, no significant differences in any of the measured variables were found between those who had RP all year and those who had RP in the winter only, those with RP of the hands only and of hands and feet, or those with and without digital ulcers. Conclusion - Diminished plasma fibrinolysis is found in patients likely to have endothelial damage (CTD RS and athero RS). These changes are probably a consequence rather than a cause of the disease.en_US
dc.languageengen_US
dc.publisherB M J Publishing Group. The Journal's web site is located at http://ard.bmjjournals.com/en_US
dc.relation.ispartofAnnals of the Rheumatic Diseasesen_US
dc.subject.meshArteriosclerosis - Complicationsen_US
dc.subject.meshConnective Tissue Diseases - Complicationsen_US
dc.subject.meshFemaleen_US
dc.subject.meshFibrinogen - Analysisen_US
dc.subject.meshFibrinolysis - Physiologyen_US
dc.subject.meshFibrinopeptide A - Analysisen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRaynaud Disease - Blood - Complications - Metabolismen_US
dc.subject.meshVon Willebrand Factor - Analysisen_US
dc.titleBaseline plasma fibrinolysis and its correlation with clinical manifestations in patients with Raynaud's phenomenonen_US
dc.typeArticleen_US
dc.identifier.emailLau, CS:cslau@hku.hken_US
dc.identifier.authorityLau, CS=rp01348en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1136/ard.52.6.443-
dc.identifier.pmid8323396-
dc.identifier.scopuseid_2-s2.0-0027326897en_US
dc.identifier.volume52en_US
dc.identifier.issue6en_US
dc.identifier.spage443en_US
dc.identifier.epage448en_US
dc.identifier.isiWOS:A1993LE51200006-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridLau, CS=14035682100en_US
dc.identifier.scopusauthoridMcLaren, M=7005471705en_US
dc.identifier.scopusauthoridMackay, I=7202234474en_US
dc.identifier.scopusauthoridBelch, JJF=7101752870en_US

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