ALTERATIONS IN FIBRIN CLOT RESISTANCE FOR PATIENTS WITH DYSLIPOPROTEINEMIA

Abstract

Background. Hyperlopoproteinemia is associated with an increased incidence of thrombotic complications due to the high thrombotic risk, for example as a result of continuous platelet activation or increased thrombin production. Purpose. In this study, we aim to emphasize hemostatic anomalies in patients with hyperlipoproteinemia. Therefore, we have chosen fibrinresistometry as the main method for evaluating hemostatic anomalies, since it measures the breakage resistance of the fibrin clot (BRFC). The major objective of our research is to study the possible correlations between the breakage resistence of the fibrin clot and an increase in plasma lipids. Material and methods. We conducted a prospective study, investigating hemostatic anomalies in hyperlipoproteinemic patients using fibrinresistometry, and, concurrently, using classic methods of determining certain parameters of hemostasis, at a 6 months interval between the first and the second evaluation. Results. In patients with hyperlipoproteinemia (HLP) the BRFC had a mean value of 296.76±23.37 FU for the initial evaluation versus 248.64±25.71 FU for the control group. By comparison with the control group, we found a significant increase (p<0.05) in plasma fibrinogen, platelet count and mean platelet volume. The increase of BRFC is highly associated with an increase in triglycerides (r=0.585) and cholesterol (r=0.574), moderately associated with LDL (r=0.551), and show a weak inverse correlation with HDL values (r= - 0.246). A high waist circumference is highly correlated to fibrinresistometric findings (r=0.576), and to high fibrinogen values (r=0.426). In patients of the subgroup with hypolipemiant treatment, a decrease of 2.85% in BRFC was found, not statistically significant. Plasma fibrinogen had a mean value of 391 ±28.87 mg/dl and after treatment it decreased significantly (p < 0.05) to 375.91±21.17 mg/dl. Conclusions. Hyperlipoproteinemia produces the alteration of the quality of the fibrin network, which becomes more adherent to the vascular endothelium. The increased breakage resistance of the fibrin clot in the studied patients reveals a thrombogenic potential, thus making BRFC an important marker for this state.