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The APC-PCI concentration as an early marker of activation of blood coagulation A study of women on combined oral contraceptives

Bremme, K.; Hamad, R. Rafik; Berg, Elisabeth; Strandberg, Karin LU and Stenflo, Johan LU (2012) In Thrombosis Research 130(4). p.636-639
Abstract
Background: The risk of venous tromboembolism (VTE) in women taking combined oral contraceptives (COCs) is attributed to changes in coagulation and fibrinolysis. The impact of the COCs may be greater in women with preexisting thrombophilic defects. Nevertheless most women who suffer from venous thrombosis do not have any of the well known hereditary or acquired risk factors. A simple and sensitive marker of "thrombogenicity" has not been identified. Objectives: To investigate the effects of two different monophasic combined oral contraceptives (COCs) on the plasma concentrations of activated protein C-inhibitor of protein C (APC-PCI) and on comparable hemostatic factors in fertile women. Method: Forty four healthy nulliparous women with... (More)
Background: The risk of venous tromboembolism (VTE) in women taking combined oral contraceptives (COCs) is attributed to changes in coagulation and fibrinolysis. The impact of the COCs may be greater in women with preexisting thrombophilic defects. Nevertheless most women who suffer from venous thrombosis do not have any of the well known hereditary or acquired risk factors. A simple and sensitive marker of "thrombogenicity" has not been identified. Objectives: To investigate the effects of two different monophasic combined oral contraceptives (COCs) on the plasma concentrations of activated protein C-inhibitor of protein C (APC-PCI) and on comparable hemostatic factors in fertile women. Method: Forty four healthy nulliparous women with regular menstrual periods were included and randomly assigned to start with a monophasic preparation containing 30 mu g ethinylestradiol and 150 mu g levonogestrel (LNG/EE) or a preparation containing 30 mu g ethinylestradiol and 150 mu g desogestrel (DG/EE). After a wash out period of two months, treatment with the alternate preparation was initiated and continued for two more cycles. Results: The plasma concentration of the APC-PCI complex and thrombin-antithrombin complex (TAT) increased during treatment with the two COCs. During DG/EE treatment the APC-PCI complex increased significantly more than during LNG/EE (p < 0,01). The plasma concentration of D-dimer did not increase during OC treatment. Conclusion: The APC-PCI complex concentration, which serves as a marker for thrombin generation and indicates hypercoagulability, was increased during COC treatment compared to baseline. The method is a sufficiently sensitive marker to detect even small differences in the activation of coagulation. c (c) 2011 Elsevier Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thrombosis Research
volume
130
issue
4
pages
636 - 639
external identifiers
  • wos:000308919500021
  • scopus:84866256112
ISSN
1879-2472
DOI
10.1016/j.thromres.2011.11.006
language
English
LU publication?
yes
id
67d5f16b-374e-4a29-b00f-307bacc44ad5 (old id 3132836)
date added to LUP
2012-11-01 10:29:24
date last changed
2017-01-01 03:01:05
@article{67d5f16b-374e-4a29-b00f-307bacc44ad5,
  abstract     = {Background: The risk of venous tromboembolism (VTE) in women taking combined oral contraceptives (COCs) is attributed to changes in coagulation and fibrinolysis. The impact of the COCs may be greater in women with preexisting thrombophilic defects. Nevertheless most women who suffer from venous thrombosis do not have any of the well known hereditary or acquired risk factors. A simple and sensitive marker of "thrombogenicity" has not been identified. Objectives: To investigate the effects of two different monophasic combined oral contraceptives (COCs) on the plasma concentrations of activated protein C-inhibitor of protein C (APC-PCI) and on comparable hemostatic factors in fertile women. Method: Forty four healthy nulliparous women with regular menstrual periods were included and randomly assigned to start with a monophasic preparation containing 30 mu g ethinylestradiol and 150 mu g levonogestrel (LNG/EE) or a preparation containing 30 mu g ethinylestradiol and 150 mu g desogestrel (DG/EE). After a wash out period of two months, treatment with the alternate preparation was initiated and continued for two more cycles. Results: The plasma concentration of the APC-PCI complex and thrombin-antithrombin complex (TAT) increased during treatment with the two COCs. During DG/EE treatment the APC-PCI complex increased significantly more than during LNG/EE (p &lt; 0,01). The plasma concentration of D-dimer did not increase during OC treatment. Conclusion: The APC-PCI complex concentration, which serves as a marker for thrombin generation and indicates hypercoagulability, was increased during COC treatment compared to baseline. The method is a sufficiently sensitive marker to detect even small differences in the activation of coagulation. c (c) 2011 Elsevier Ltd. All rights reserved.},
  author       = {Bremme, K. and Hamad, R. Rafik and Berg, Elisabeth and Strandberg, Karin and Stenflo, Johan},
  issn         = {1879-2472},
  language     = {eng},
  number       = {4},
  pages        = {636--639},
  series       = {Thrombosis Research},
  title        = {The APC-PCI concentration as an early marker of activation of blood coagulation A study of women on combined oral contraceptives},
  url          = {http://dx.doi.org/10.1016/j.thromres.2011.11.006},
  volume       = {130},
  year         = {2012},
}