Circulating microparticles and the risk of thrombosis in inherited deficiencies of antithrombin, protein C and protein S

Elena Campello; Luca Spiezia; Claudia M. Radu; Cristiana Bulato; Sabrina Gavasso; Daniela Tormene; Barry Woodhams; Fabio Dalla Valle; Paolo Simioni

doi:10.1160/TH15-04-0286

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2016; 115(01): 81-88
DOI: 10.1160/TH15-04-0286

Coagulation and Fibrinolysis

Schattauer GmbH Schattauer

Circulating microparticles and the risk of thrombosis in inherited deficiencies of antithrombin, protein C and protein S

Authors

Elena Campello

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Luca Spiezia

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Claudia M. Radu

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Cristiana Bulato

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Sabrina Gavasso

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Daniela Tormene

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Barry Woodhams

²HaemaCon Ltd, Bromley, UK
Fabio Dalla Valle

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy
Paolo Simioni

¹Department of Medicine, 5^th Chair of Internal Medicine, Thrombophilia and Hemophilia Center, University of Padua, Italy

Abstract

Summary

Many subjects carrying inherited thrombophilic defects will never experience venous thromboembolism (VTE) while other individuals developed recurrent VTE with no known additional risk factors. High levels of circulating microparticles (MP) have been associated with increased risk of VTE in patients with factor V Leiden and prothrombin G20210A mutation, suggesting a possible contribution of MP in the hypercoagulability of mild genetic thrombophilia. The role of MP as additional risk factor of VTE in carriers of natural clotting inhibitors defects (severe thrombophilia) has never been assessed. Plasma levels of annexin V-MP, endothelial-derived MP (EMP), platelet-derived MP (PMP), tissue factor-bearing MP (TF+) and the MP procoagulant activity (PPL) were measured in 132 carriers of natural anticoagulant deficiencies (25 antithrombin, 63 protein C and 64 protein S defect) and in 132 age and gender-matched healthy controls. Carriers of natural anticoagulant deficiencies, overall and separately considered, presented with higher median levels of annexin V-MP, EMP, PMP, TF+MP and PPL activity than healthy controls (p< 0.001, < 0.001, < 0.01, 0.025 and 0.03, respectively). Symptomatic carriers with a previous episode of VTE had significantly higher median levels of annexin-V MP than those without VTE (p=0.027). Carriers with high levels of annexin V-MP, EMP and PMP had an adjusted OR for VTE of 3.36 (95 % CI, 1.59 to 7.11), 9.26 (95 % CI, 3.55 to 24.1) and 2.72 (95 %CI, 1.16 to 6.38), respectively. Elevated levels of circulating MP can play a role in carriers of mild and severe inherited thrombophilia. The clinical implications of this association remain to be defined.

Keywords

Coagulation inhibitors - hypercoagulability - microparticles - thrombophilia - venous thrombosis

Full Text

References

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