Coagulopathy in patients with acute pulmonary embolism: a pilot study of whole blood coagulation and markers of endothelial damage

Per Lehnert; Pär I Johansson; Sisse R Ostrowski; Christian H Møller; Lia E Bang; Peter Skov Olsen; Jørn Carlsen

doi:10.1080/00365513.2016.1239130

Coagulopathy in patients with acute pulmonary embolism: a pilot study of whole blood coagulation and markers of endothelial damage

Per Lehnert, Pär I Johansson, Sisse R Ostrowski, Christian H Møller, Lia E Bang, Peter Skov Olsen, Jørn Carlsen

Department of Clinical Medicine

7 Citations (Scopus)

Abstract

Whole blood coagulation and markers of endothelial damage were studied in patients with acute pulmonary embolism (PE), and evaluated in relation to PE severity. Twenty-five patients were enrolled prospectively each having viscoelastical analysis of whole blood done using thrombelastography (TEG) and Multiplate aggregometry. Fourteen of these patients were investigated for endothelial damage by ELISA measurements of Syndecan-1 (endothelial glycocalyx degradation), soluble endothelial Selectin (endothelial cell activation), soluble Thrombomodulin (endothelial cell injury) and Histone Complexed DNA fragments (endothelial cytotoxic histones). The mean values of TEG and Multiplate parameters were all within the reference levels, but a significant difference between patients with high and intermediate risk PE was observed for Ly30 (lytic activity) 1.5% [0-10] vs. 0.2% [0-2.2] p = .04, and ADP (platelet reactivity) 92 U [20-145] vs. 59 U [20-111] p = .03. A similar difference was indicated for functional fibrinogen 21 mm [17-29] vs. 18 mm [3-23] p = .05. Analysis of endothelial markers identified a significant difference in circulating levels between high and intermediate risk PE patients for Syndecan-1 118.6 ng/mL [76-133] vs. 36.3 ng/mL [11.8-102.9] p = .008. In conclusion, patients with acute PE had normal whole blood coagulation, but high risk PE patients had signs of increased activity of the haemostatic system and significantly increased level of endothelial glycocalyx degradation.

Original language	English
Journal	Scandinavian Journal of Clinical & Laboratory Investigation
Volume	77
Issue number	1
Pages (from-to)	19-26
Number of pages	8
ISSN	0036-5513
DOIs	https://doi.org/10.1080/00365513.2016.1239130
Publication status	Published - 2 Jan 2017

Keywords

Acute Disease
Adult
Aged
Aged, 80 and over
Biomarkers
Blood Coagulation
Blood Platelets
E-Selectin
Endothelium, Vascular
Female
Fibrinogen
Glycocalyx
Histones
Humans
Male
Middle Aged
Pilot Projects
Platelet Aggregation
Pulmonary Embolism
Severity of Illness Index
Syndecan-1
Thrombelastography
Thrombomodulin
Journal Article

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10.1080/00365513.2016.1239130

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Coagulopathy in patients with acute pulmonary embolism: a pilot study of whole blood coagulation and markers of endothelial damage. / Lehnert, Per; Johansson, Pär I; Ostrowski, Sisse R et al.
In: Scandinavian Journal of Clinical & Laboratory Investigation, Vol. 77, No. 1, 02.01.2017, p. 19-26.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Coagulopathy in patients with acute pulmonary embolism: a pilot study of whole blood coagulation and markers of endothelial damage",

abstract = "Whole blood coagulation and markers of endothelial damage were studied in patients with acute pulmonary embolism (PE), and evaluated in relation to PE severity. Twenty-five patients were enrolled prospectively each having viscoelastical analysis of whole blood done using thrombelastography (TEG) and Multiplate aggregometry. Fourteen of these patients were investigated for endothelial damage by ELISA measurements of Syndecan-1 (endothelial glycocalyx degradation), soluble endothelial Selectin (endothelial cell activation), soluble Thrombomodulin (endothelial cell injury) and Histone Complexed DNA fragments (endothelial cytotoxic histones). The mean values of TEG and Multiplate parameters were all within the reference levels, but a significant difference between patients with high and intermediate risk PE was observed for Ly30 (lytic activity) 1.5% [0-10] vs. 0.2% [0-2.2] p = .04, and ADP (platelet reactivity) 92 U [20-145] vs. 59 U [20-111] p = .03. A similar difference was indicated for functional fibrinogen 21 mm [17-29] vs. 18 mm [3-23] p = .05. Analysis of endothelial markers identified a significant difference in circulating levels between high and intermediate risk PE patients for Syndecan-1 118.6 ng/mL [76-133] vs. 36.3 ng/mL [11.8-102.9] p = .008. In conclusion, patients with acute PE had normal whole blood coagulation, but high risk PE patients had signs of increased activity of the haemostatic system and significantly increased level of endothelial glycocalyx degradation.",

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author = "Per Lehnert and Johansson, {P{\"a}r I} and Ostrowski, {Sisse R} and M{\o}ller, {Christian H} and Bang, {Lia E} and Olsen, {Peter Skov} and J{\o}rn Carlsen",

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T2 - a pilot study of whole blood coagulation and markers of endothelial damage

AU - Lehnert, Per

AU - Johansson, Pär I

AU - Ostrowski, Sisse R

AU - Møller, Christian H

AU - Bang, Lia E

AU - Olsen, Peter Skov

AU - Carlsen, Jørn

PY - 2017/1/2

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N2 - Whole blood coagulation and markers of endothelial damage were studied in patients with acute pulmonary embolism (PE), and evaluated in relation to PE severity. Twenty-five patients were enrolled prospectively each having viscoelastical analysis of whole blood done using thrombelastography (TEG) and Multiplate aggregometry. Fourteen of these patients were investigated for endothelial damage by ELISA measurements of Syndecan-1 (endothelial glycocalyx degradation), soluble endothelial Selectin (endothelial cell activation), soluble Thrombomodulin (endothelial cell injury) and Histone Complexed DNA fragments (endothelial cytotoxic histones). The mean values of TEG and Multiplate parameters were all within the reference levels, but a significant difference between patients with high and intermediate risk PE was observed for Ly30 (lytic activity) 1.5% [0-10] vs. 0.2% [0-2.2] p = .04, and ADP (platelet reactivity) 92 U [20-145] vs. 59 U [20-111] p = .03. A similar difference was indicated for functional fibrinogen 21 mm [17-29] vs. 18 mm [3-23] p = .05. Analysis of endothelial markers identified a significant difference in circulating levels between high and intermediate risk PE patients for Syndecan-1 118.6 ng/mL [76-133] vs. 36.3 ng/mL [11.8-102.9] p = .008. In conclusion, patients with acute PE had normal whole blood coagulation, but high risk PE patients had signs of increased activity of the haemostatic system and significantly increased level of endothelial glycocalyx degradation.

AB - Whole blood coagulation and markers of endothelial damage were studied in patients with acute pulmonary embolism (PE), and evaluated in relation to PE severity. Twenty-five patients were enrolled prospectively each having viscoelastical analysis of whole blood done using thrombelastography (TEG) and Multiplate aggregometry. Fourteen of these patients were investigated for endothelial damage by ELISA measurements of Syndecan-1 (endothelial glycocalyx degradation), soluble endothelial Selectin (endothelial cell activation), soluble Thrombomodulin (endothelial cell injury) and Histone Complexed DNA fragments (endothelial cytotoxic histones). The mean values of TEG and Multiplate parameters were all within the reference levels, but a significant difference between patients with high and intermediate risk PE was observed for Ly30 (lytic activity) 1.5% [0-10] vs. 0.2% [0-2.2] p = .04, and ADP (platelet reactivity) 92 U [20-145] vs. 59 U [20-111] p = .03. A similar difference was indicated for functional fibrinogen 21 mm [17-29] vs. 18 mm [3-23] p = .05. Analysis of endothelial markers identified a significant difference in circulating levels between high and intermediate risk PE patients for Syndecan-1 118.6 ng/mL [76-133] vs. 36.3 ng/mL [11.8-102.9] p = .008. In conclusion, patients with acute PE had normal whole blood coagulation, but high risk PE patients had signs of increased activity of the haemostatic system and significantly increased level of endothelial glycocalyx degradation.

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KW - Blood Platelets

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KW - Endothelium, Vascular

KW - Female

KW - Fibrinogen

KW - Glycocalyx

KW - Histones

KW - Humans

KW - Male

KW - Middle Aged

KW - Pilot Projects

KW - Platelet Aggregation

KW - Pulmonary Embolism

KW - Severity of Illness Index

KW - Syndecan-1

KW - Thrombelastography

KW - Thrombomodulin

KW - Journal Article

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DO - 10.1080/00365513.2016.1239130

M3 - Journal article

C2 - 27724023

SN - 0036-5513

VL - 77

SP - 19

EP - 26

JO - Scandinavian Journal of Clinical & Laboratory Investigation

JF - Scandinavian Journal of Clinical & Laboratory Investigation

IS - 1

ER -

Coagulopathy in patients with acute pulmonary embolism: a pilot study of whole blood coagulation and markers of endothelial damage

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Keywords

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