Fibrinolytic Changes in Women with Preeclampsia

Anne Cathrine Godtfredsen, Johannes Jakobsen Sidelmann, Britta Blume Dolleris, Jan Stener Jørgensen, Emma Kathrine Jungjohan Johansen, Melissa Fernard Bøg Pedersen, Yaseelan Palarasah, Jørgen Brodersen Gram

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Abstract

OBJECTIVES: Preeclampsia (PE) is a serious complication of pregnancy. The fibrinolytic system play crucial roles regarding placentation and evolution of PE.

AIM: To study comprehensively components of the fibrinolytic system and fibrin lysability in women with PE.

DESIGN AND METHODS: 117 women with PE and matched controls were included. Tissue type plasminogen activator (t-PA), plasminogen, PAI-1, plasmin inhibitor (PI), D-dimer, the fibrinolytic potential of dextran sulphate euglobulin fraction (DEF), PAI-2, polymere PAI-2, fibrin clot lysability, thrombin activatable fibrinolysis inhibitor (TAFI) and fibrinogen were assessed.

RESULTS: Women with PE had significantly increased concentrations of t-PA and PAI-1, whereas the plasma concentration of PAI-2 was significantly lower compared to controls, p < 0.0001. Polymere PAI-2 was detected in both groups. DEF, TAFI and fibrinogen were not different between the groups. D-dimer was significantly increased and plasminogen/PI together with fibrin clot lysability time decreased in the PE-group, p  =  0.0004 p  =  0.04, p  =  0.03, p < 0.0001 respectively.

CONCLUSION: This study demonstrates that PE is associated with an affected t-PA/PAI-1 system, decreased PAI-2 and increased fibrin lysability. Furthermore, PAI-2 has the potential to polymerize during pregnancy.

Keywords

  • PAI-2
  • fibrin lysability
  • fibrinolysis
  • preeclampsia
  • protein polymerization

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