Volumen: 13 # Number : 2
Publication Date : Mayo - Agosto Year: 2009
Authors: Yolanda P Adamczuk, María Luisa Iglesias Varela, Graciela S Cerrato, Ricardo R Forastiero, Marta E Martinuzzo
Abstract: Evaluation of prothrombotic polymorphisms and fibrinolytic
tests in patients with history of obstetric complications.
The presence of prothrombotic polymorphisms as well
as some fibrinolysis alterations was depicted in patients
with recurrent pregnancy loss (RPL); but there are no clear
conclusions about their associations with fertilization procedure
failure (FPF). The aim of this study was to evaluate
the presence of prothrombotic polymorphisms (factor V
Leiden, PT 20210 y PAI-1 promoter polymorphism 4G5G)
in 147 women with history of RPL and fibrinolytic tests:
PAI-1 antigen, euglobulin lysis time (ELT) pre and post
venous occlusion (VO) and PAI 4G5G in 92 women referred
for RPL (n=49), or FPF (n=43). There was a statistic association
between the presence of Factor V Leiden and late
pregnancy loss, p=0.03. The other polymorphisms did not
show statistic association with RPL, except a trend for PAI
4G4G (p=0.08). PAI 1 levels and the fibrinolytic response
were not associated with PAI polymorphism considering all
patients. The prevalence of very poor fibrinolytic response
(PFR) to VO was 17.9% and that of slightly poor in 19.3%
in the patients. PAI-1 levels were higher in women with
classical risk factors for cardiovascular disease (CVD), particularly
in those with 4G4G homozygous genotype. PAI1, as well as pre and post VO ELT correlated with Body
Mass Index.
In this group of patients, only factor V Leiden was associated
with late PL. The prothrombotic polymorphisms
were not associated to early RPL or FPF. Moreover, in these
healthy and young women PAI-1 levels and fibrinolytic
response to VO were not associated with PAI polymorphism,
except in patients with classical risk factors of CVD,
which were the main variables associated with hypofibrinolysis.
Key words: prothrombotic polymorphisms, PAI 1, PAI
1 promoter polymorphism, pregnancy loss, cardiovascular
disease risk factors
Pages : 41-48
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