Impairment of the Plasmin Activation System in Primary Pulmonary Hypertension: Evidence for Gender Differences

Günter Christ; Senta Graf; Renate Huber-Beckmann; Gerlinde Zorn; Irene Lang; Meinhard Kneussl; Bernd R. Binder; Kurt Huber

doi:10.1055/s-0037-1616086

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2001; 86(02): 557-562
DOI: 10.1055/s-0037-1616086

Review Article

Schattauer GmbH

Impairment of the Plasmin Activation System in Primary Pulmonary Hypertension: Evidence for Gender Differences

Günter Christ

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

,

Senta Graf

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

,

Renate Huber-Beckmann

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

,

Gerlinde Zorn

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

,

Irene Lang

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

,

Meinhard Kneussl

²Department of Pulmonary Medicine, University of Vienna, Austria

,

Bernd R. Binder

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

,

Kurt Huber

¹Department of Cardiology, Department of Vascular Biology and Thrombosis Research

› Author Affiliations

Abstract

Summary

Primary pulmonary hypertension (PPH) is a rare disorder, with marked in-situ thrombosis of small pulmonary vessels occurring primarily in adult women. We investigated whether differences in the plasmin- and thrombin activation system are associated with the predominate affection of females. Plasma levels of plasminogen activator inhibitor type 1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, thrombin-antithrombin (TAT) complexes, and prothrombin fragments (F1.2) were measured at baseline and after standardized venous occlusion (VO) in patients with PPH (24 female, 9 male). At baseline, females showed significant higher TAT levels (p = 0.05), higher t-PA antigen levels (p = 0.01) and higher fibrinogen levels (p = 0.03) with positive correlation to mean pulmonary artery pressure (mPAP), as well as nonsignificant lower t-PA activity, higher PAI-1 antigen and activity and F1.2 levels. After VO, females showed a significantly blunted increase in t-PA antigen (p = 0.01) and t-PA activity (p = 0.001), correlating with mPAP, as well as increased PAI-1 activity (p = 0.05). We hypothesize, that the observed presence of gender differences in the plasmin- and thrombin activation system in PPH leading to an antifibrinolytic/prothrombotic state might, in part, explain the female predominant incidence of this disease.

Keywords

Primary pulmonary hypertension - fibrinolysis - blood coagulation - gender

Full Text

References

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