- Email: [email protected]
P-005: Venous thromboembolism risk in pregnant women with antithrombin deficiency
Abstracts / Thrombosis Research 151, Suppl. 1 (2017) S103–S140
P-004 Age-related risk of venous thromboembolism in women with antithrombin deficiency
P-006 Composition of soluble fibrin monomer complex in plasma of patients with ischemic stroke
A.L. Marshall 1 *, J. Perez Botero 1 , D.J. Crusan 2 , T.M. Petterson 2 , J.C. Guenther 3 , A.V. Chintakuntlawar 4 , R.K. Pruthi 1,3 , A.A. Ashrani 1,3 , J.A. Heit 1,3 , M.S. Patnaik 1,3 1 Division of Hematology, Mayo Clinic, Rochester, MN, USA; 2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; 3 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; 4 Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA; *E-mail: [email protected]
N. Shabanova*, T. Katrii, O. Savchuk Department of Biochemistry, Educational and Scientific Center “Institute of Biology”, Taras Shevchenko National University of Kyiv, Ukraine *E-mail: [email protected]
Background: Congenital antithrombin (AT) deficiency is associated with an estimated 20–50% lifetime risk of venous thromboembolism (VTE). VTE risk is known to increase with age in all women, but the relationship between AT deficiency and age-related risk of V TE has not been explored. We sought to quantify age-related risk of V TE in women with AT deficiency. Methods: We performed a retrospective review of female Mayo Clinic patients with congenital AT deficiency. Medical records were reviewed for evidence of VTE. Patients were followed from birth to first VTE, last medical visit, or death. Rochester Epidemiology Project, Olmsted County (OC) VTE incidence rates, 1981–2010, of women ages 0–14, 15–24, 25–34, 35–44, and 45–54 were used to calculate the expected number of VTE in standardized morbidity ratios (SMR). Results: Twenty-six women with AT deficiency were included. Women with AT deficiency had a significantly increased risk of VTE compared to the OC population at all ages from 0–54 (SMR=129, 95% CI 77–201). The risk was highest in the youngest age groups: SMR=525 and 376 for ages 0–14 and 15–24, respectively, versus SMR=32 for ages 45–54 (p-values<0.05). Conclusions: Women with AT deficiency were at significantly increased risk of VTE compared to women without AT deficiency, and the increased risk was most pronounced in younger patients. This may reflect a multiplicative risk of oral contraceptive exposure in women with AT deficiency. Reproductive health counseling starting at a young age may reduce the risk of VTE in women with AT deficiency.
S111
Introduction: Stroke is defined as acute cerebrovascular accident, which is characterized by structural and morphological changes in the brain tissue and persistent neurological deficits. Despite frequency of this disease, mankind has only a superficial understanding of the processes of ischemia and changes in hemostasis that accompany it. It is known, the concentration of soluble fibrin monomer complex (SFMC) acts as a marker of haemostatic cascade deviation. Considering the features of imbalances leading to a hypercoagulation, we set the goal to determine the composition of SFMC fractions in plasma of patients with ischemic stroke. Methods and results: Soluble fibrin monomer complex were separated from the blood plasma of healthy donors, patients with atherothrombotic (AIS) and cardioembolic ischemic stroke (CIS) in acute phase of disease and the same patients one year past acute phase. SFMC were collected by o-phenanthroline method which used for diagnosis. Composition characterization of each SFMC was performed by the size exclusion chromatographic separation on S200 column in 50 mM Tris-HCl, pH 7.4 with the addition of 0.13 M NaCl. The stable speed was1 ml/min.
P-005 Venous thromboembolism risk in pregnant women with antithrombin deficiency A.L. Marshall 1 , J.P. Botero 1 , D.J. Crusan 2 , T.M. Petterson 2 , J.C. Guenther 3 , A.V. Chintakuntlawar 4 , R.K. Pruthi 1,3 , A.A. Ashrani 1,3 , J.A. Heit 1,3 , M.S. Patnaik 1,3 1 Division of Hematology, Mayo Clinic, Rochester, MN, USA; 2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; 3 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; 4 Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA Background: Congenital antithrombin (AT) deficiency is associated with a significantly lifetime risk of venous thromboembolism (VTE). Pregnancy is a risk factor for VTE in all women of child-bearing age. We sought to characterize the risk of pregnancy-associated VTE in women with AT deficiency. Methods: We conducted a retrospective review of female patients with congenital AT deficiency. Medical records were reviewed for pregnancy history, evidence of VTE, and hormonal exposure or pregnancy at the time of VTE. The Rochester Epidemiology Project study, Olmsted County VTE incidence rate (1966–1995) among pregnant women, age 15–44, was used to calculate the standardized morbidity ratio (SMR) of VTE during pregnancy among AT deficient patients with a pregnancy history. Only the 1 year of pregnancy risk (9 months of pregnancy and 3 months post-partum) was considered. Results: Twenty-six women with AT deficiency were included in the study. 4 of 26 women experienced a pregnancy-associated VTE. Women with AT deficiency were at significantly higher risk of pregnancy-related VTE compared to the OC population VTE incidence rates among pregnant women ages 15–44 (SMR=40, 95% CI 11–104). Conclusions: Women with AT deficiency were at significantly increased risk of pregnancy-associated VTE compared to women without AT deficiency. Campaigns to increase physician awareness regarding AT deficiency, careful reproductive health counseling, and patient-oriented decision making strategies may all be helpful to reduce risk of pregnancy-related VTE in women with AT deficiency.
Figure 1. Size-exclusion chromatography of SFMC obtained from the blood plasma of healthy donors and patients with ischemic stroke.
Conclusion: It was shown that the development of ischemic stroke accompanied by the formation of SFMC in the bloodstream that could take part in disease complication. Results suggest presence of proteins with Mr from 97 to 330 kDa. Composition difference of stroke SFMC fractions were showed comparing to the healthy donors SFMC fractions.
P-007 Prolonged low-molecular-weight heparin use during pregnancy and subsequent bone mineral density P. Galambosi 1 *, V. Hiilesmaa 1 , V.M. Ulander 1 , L. Laitinen 1 , A. Tiitinen 1 , R. Kaaja 2 1 University of Helsinki, Helsinki University Hospital, Department of Obstetrics and Gynaecology, Finland; 2 University of Turku and Turku University Central Hospital, Finland *Presentig author: Päivi Galambosi; paivi.galambosi@hus.fi Introduction: LMWH during pregnancy has not been reported to be associated with a significant decrease in bone mineral density (BMD). The aim of this study was to investigate whether long-term use of LMWH during pregnancy is associated with subsequent decrease in BMD or with increased number of osteoporotic fractures. Materials and methods: In this observational cohort study BMD was measured by dual energy X-ray absorptiometry (DEXA) 4–7 years after the last delivery in 152 women (92 with LMWH-exposure and 60 without that). A questionnaire about lifestyle factors and medical history was filled out by the subjects. Results: Lumbar spine BMD in the LMWH users was lower than that in the controls both in the prophylactic group (1.22 g/cm2 vs. 1.27 g/cm2 ; p=0.03), and in the treatment group (1.20 g/cm2 vs. 1.27 g/cm2 ; p=0.07). BMD in
P-004 Age-related risk of venous thromboembolism in women with antithrombin deficiency
P-006 Composition of soluble fibrin monomer complex in plasma of patients with ischemic stroke
A.L. Marshall 1 *, J. Perez Botero 1 , D.J. Crusan 2 , T.M. Petterson 2 , J.C. Guenther 3 , A.V. Chintakuntlawar 4 , R.K. Pruthi 1,3 , A.A. Ashrani 1,3 , J.A. Heit 1,3 , M.S. Patnaik 1,3 1 Division of Hematology, Mayo Clinic, Rochester, MN, USA; 2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; 3 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; 4 Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA; *E-mail: [email protected]
N. Shabanova*, T. Katrii, O. Savchuk Department of Biochemistry, Educational and Scientific Center “Institute of Biology”, Taras Shevchenko National University of Kyiv, Ukraine *E-mail: [email protected]
Background: Congenital antithrombin (AT) deficiency is associated with an estimated 20–50% lifetime risk of venous thromboembolism (VTE). VTE risk is known to increase with age in all women, but the relationship between AT deficiency and age-related risk of V TE has not been explored. We sought to quantify age-related risk of V TE in women with AT deficiency. Methods: We performed a retrospective review of female Mayo Clinic patients with congenital AT deficiency. Medical records were reviewed for evidence of VTE. Patients were followed from birth to first VTE, last medical visit, or death. Rochester Epidemiology Project, Olmsted County (OC) VTE incidence rates, 1981–2010, of women ages 0–14, 15–24, 25–34, 35–44, and 45–54 were used to calculate the expected number of VTE in standardized morbidity ratios (SMR). Results: Twenty-six women with AT deficiency were included. Women with AT deficiency had a significantly increased risk of VTE compared to the OC population at all ages from 0–54 (SMR=129, 95% CI 77–201). The risk was highest in the youngest age groups: SMR=525 and 376 for ages 0–14 and 15–24, respectively, versus SMR=32 for ages 45–54 (p-values<0.05). Conclusions: Women with AT deficiency were at significantly increased risk of VTE compared to women without AT deficiency, and the increased risk was most pronounced in younger patients. This may reflect a multiplicative risk of oral contraceptive exposure in women with AT deficiency. Reproductive health counseling starting at a young age may reduce the risk of VTE in women with AT deficiency.
S111
Introduction: Stroke is defined as acute cerebrovascular accident, which is characterized by structural and morphological changes in the brain tissue and persistent neurological deficits. Despite frequency of this disease, mankind has only a superficial understanding of the processes of ischemia and changes in hemostasis that accompany it. It is known, the concentration of soluble fibrin monomer complex (SFMC) acts as a marker of haemostatic cascade deviation. Considering the features of imbalances leading to a hypercoagulation, we set the goal to determine the composition of SFMC fractions in plasma of patients with ischemic stroke. Methods and results: Soluble fibrin monomer complex were separated from the blood plasma of healthy donors, patients with atherothrombotic (AIS) and cardioembolic ischemic stroke (CIS) in acute phase of disease and the same patients one year past acute phase. SFMC were collected by o-phenanthroline method which used for diagnosis. Composition characterization of each SFMC was performed by the size exclusion chromatographic separation on S200 column in 50 mM Tris-HCl, pH 7.4 with the addition of 0.13 M NaCl. The stable speed was1 ml/min.
P-005 Venous thromboembolism risk in pregnant women with antithrombin deficiency A.L. Marshall 1 , J.P. Botero 1 , D.J. Crusan 2 , T.M. Petterson 2 , J.C. Guenther 3 , A.V. Chintakuntlawar 4 , R.K. Pruthi 1,3 , A.A. Ashrani 1,3 , J.A. Heit 1,3 , M.S. Patnaik 1,3 1 Division of Hematology, Mayo Clinic, Rochester, MN, USA; 2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; 3 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; 4 Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA Background: Congenital antithrombin (AT) deficiency is associated with a significantly lifetime risk of venous thromboembolism (VTE). Pregnancy is a risk factor for VTE in all women of child-bearing age. We sought to characterize the risk of pregnancy-associated VTE in women with AT deficiency. Methods: We conducted a retrospective review of female patients with congenital AT deficiency. Medical records were reviewed for pregnancy history, evidence of VTE, and hormonal exposure or pregnancy at the time of VTE. The Rochester Epidemiology Project study, Olmsted County VTE incidence rate (1966–1995) among pregnant women, age 15–44, was used to calculate the standardized morbidity ratio (SMR) of VTE during pregnancy among AT deficient patients with a pregnancy history. Only the 1 year of pregnancy risk (9 months of pregnancy and 3 months post-partum) was considered. Results: Twenty-six women with AT deficiency were included in the study. 4 of 26 women experienced a pregnancy-associated VTE. Women with AT deficiency were at significantly higher risk of pregnancy-related VTE compared to the OC population VTE incidence rates among pregnant women ages 15–44 (SMR=40, 95% CI 11–104). Conclusions: Women with AT deficiency were at significantly increased risk of pregnancy-associated VTE compared to women without AT deficiency. Campaigns to increase physician awareness regarding AT deficiency, careful reproductive health counseling, and patient-oriented decision making strategies may all be helpful to reduce risk of pregnancy-related VTE in women with AT deficiency.
Figure 1. Size-exclusion chromatography of SFMC obtained from the blood plasma of healthy donors and patients with ischemic stroke.
Conclusion: It was shown that the development of ischemic stroke accompanied by the formation of SFMC in the bloodstream that could take part in disease complication. Results suggest presence of proteins with Mr from 97 to 330 kDa. Composition difference of stroke SFMC fractions were showed comparing to the healthy donors SFMC fractions.
P-007 Prolonged low-molecular-weight heparin use during pregnancy and subsequent bone mineral density P. Galambosi 1 *, V. Hiilesmaa 1 , V.M. Ulander 1 , L. Laitinen 1 , A. Tiitinen 1 , R. Kaaja 2 1 University of Helsinki, Helsinki University Hospital, Department of Obstetrics and Gynaecology, Finland; 2 University of Turku and Turku University Central Hospital, Finland *Presentig author: Päivi Galambosi; paivi.galambosi@hus.fi Introduction: LMWH during pregnancy has not been reported to be associated with a significant decrease in bone mineral density (BMD). The aim of this study was to investigate whether long-term use of LMWH during pregnancy is associated with subsequent decrease in BMD or with increased number of osteoporotic fractures. Materials and methods: In this observational cohort study BMD was measured by dual energy X-ray absorptiometry (DEXA) 4–7 years after the last delivery in 152 women (92 with LMWH-exposure and 60 without that). A questionnaire about lifestyle factors and medical history was filled out by the subjects. Results: Lumbar spine BMD in the LMWH users was lower than that in the controls both in the prophylactic group (1.22 g/cm2 vs. 1.27 g/cm2 ; p=0.03), and in the treatment group (1.20 g/cm2 vs. 1.27 g/cm2 ; p=0.07). BMD in