Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis
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2022
Authors
Colić, JelenaPruner, Iva
Damjanov, Nemanja
Pekmezović, Tatjana
Sefik-Bukilica, Mirjana
Antović, Aleksandra
Article (Published version)
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Objective. To assess thrombin generation, fibrin formation, and structure together with the fibrinolytic status in patients with systemic sclerosis (SSc) in relation to the occurrence of digital ulcers (DUs) during the course of disease. Methods. We studied variables of endothelial dysfunction, thrombin generation, overall hemostatic potential, and fibrin clot turbidity in plasma from 58 patients with SSc (39 with DU history and 19 DU-naive) and 46 matched healthy controls (HCs). Fibrin structure was visualized using scanning electron microscopy (SEM). Finally, 39 patients with a history of DUs were followed for 1.5 years and the predictive value of all investigated markers for new DU onset was explored. Results. Significantly enhanced endogenous thrombin potential (ETP) and prolonged clot lysis time (CLT) were found in patients with DUs compared to HCs. CLT was prolonged in patients with DUs compared to those without, showing good validity in identifying DUs with an area under the cur...ve of 0.7 (95% CI 0.6-0.8). The levels of ETP and intercellular adhesion molecule 1 were independently associated with CLT. Over the follow-up period, 20 patients developed new DUs. CLT was prolonged (P lt 0.001) in patients with new DU episodes, especially those with recurrent DUs. Regression analysis showed that the Raynaud phenomenon visual analog scale and CLT were predictors of new DUs (OR 1.1, 95% CI 1.0-1.1 and OR 1.2, 95% CI 1.1-1.3, respectively). SEM confirmed denser fibrin clots in patients with new DUs. Conclusion. Our results suggest that impaired fibrinolysis might have an emerging role in underlying digital vasculopathy and its progression in SSc.
Keywords:
systemic sclerosis / hemostasis / fibrin structure / digital ulcers / clot lysis timeSource:
Journal of Rheumatology, 2022, 49, 6, 598-606Publisher:
- Toronto : J Rheumatol Publ Co.
DOI: 10.3899/jrheum.210931
ISSN: 0315-162X
PubMed: 35169064
WoS: 000833533100009
Scopus: 2-s2.0-85131269599
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Institut za molekularnu genetiku i genetičko inženjerstvoTY - JOUR AU - Colić, Jelena AU - Pruner, Iva AU - Damjanov, Nemanja AU - Pekmezović, Tatjana AU - Sefik-Bukilica, Mirjana AU - Antović, Aleksandra PY - 2022 UR - https://imagine.imgge.bg.ac.rs/handle/123456789/1536 AB - Objective. To assess thrombin generation, fibrin formation, and structure together with the fibrinolytic status in patients with systemic sclerosis (SSc) in relation to the occurrence of digital ulcers (DUs) during the course of disease. Methods. We studied variables of endothelial dysfunction, thrombin generation, overall hemostatic potential, and fibrin clot turbidity in plasma from 58 patients with SSc (39 with DU history and 19 DU-naive) and 46 matched healthy controls (HCs). Fibrin structure was visualized using scanning electron microscopy (SEM). Finally, 39 patients with a history of DUs were followed for 1.5 years and the predictive value of all investigated markers for new DU onset was explored. Results. Significantly enhanced endogenous thrombin potential (ETP) and prolonged clot lysis time (CLT) were found in patients with DUs compared to HCs. CLT was prolonged in patients with DUs compared to those without, showing good validity in identifying DUs with an area under the curve of 0.7 (95% CI 0.6-0.8). The levels of ETP and intercellular adhesion molecule 1 were independently associated with CLT. Over the follow-up period, 20 patients developed new DUs. CLT was prolonged (P lt 0.001) in patients with new DU episodes, especially those with recurrent DUs. Regression analysis showed that the Raynaud phenomenon visual analog scale and CLT were predictors of new DUs (OR 1.1, 95% CI 1.0-1.1 and OR 1.2, 95% CI 1.1-1.3, respectively). SEM confirmed denser fibrin clots in patients with new DUs. Conclusion. Our results suggest that impaired fibrinolysis might have an emerging role in underlying digital vasculopathy and its progression in SSc. PB - Toronto : J Rheumatol Publ Co. T2 - Journal of Rheumatology T1 - Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis EP - 606 IS - 6 SP - 598 VL - 49 DO - 10.3899/jrheum.210931 ER -
@article{ author = "Colić, Jelena and Pruner, Iva and Damjanov, Nemanja and Pekmezović, Tatjana and Sefik-Bukilica, Mirjana and Antović, Aleksandra", year = "2022", abstract = "Objective. To assess thrombin generation, fibrin formation, and structure together with the fibrinolytic status in patients with systemic sclerosis (SSc) in relation to the occurrence of digital ulcers (DUs) during the course of disease. Methods. We studied variables of endothelial dysfunction, thrombin generation, overall hemostatic potential, and fibrin clot turbidity in plasma from 58 patients with SSc (39 with DU history and 19 DU-naive) and 46 matched healthy controls (HCs). Fibrin structure was visualized using scanning electron microscopy (SEM). Finally, 39 patients with a history of DUs were followed for 1.5 years and the predictive value of all investigated markers for new DU onset was explored. Results. Significantly enhanced endogenous thrombin potential (ETP) and prolonged clot lysis time (CLT) were found in patients with DUs compared to HCs. CLT was prolonged in patients with DUs compared to those without, showing good validity in identifying DUs with an area under the curve of 0.7 (95% CI 0.6-0.8). The levels of ETP and intercellular adhesion molecule 1 were independently associated with CLT. Over the follow-up period, 20 patients developed new DUs. CLT was prolonged (P lt 0.001) in patients with new DU episodes, especially those with recurrent DUs. Regression analysis showed that the Raynaud phenomenon visual analog scale and CLT were predictors of new DUs (OR 1.1, 95% CI 1.0-1.1 and OR 1.2, 95% CI 1.1-1.3, respectively). SEM confirmed denser fibrin clots in patients with new DUs. Conclusion. Our results suggest that impaired fibrinolysis might have an emerging role in underlying digital vasculopathy and its progression in SSc.", publisher = "Toronto : J Rheumatol Publ Co.", journal = "Journal of Rheumatology", title = "Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis", pages = "606-598", number = "6", volume = "49", doi = "10.3899/jrheum.210931" }
Colić, J., Pruner, I., Damjanov, N., Pekmezović, T., Sefik-Bukilica, M.,& Antović, A.. (2022). Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis. in Journal of Rheumatology Toronto : J Rheumatol Publ Co.., 49(6), 598-606. https://doi.org/10.3899/jrheum.210931
Colić J, Pruner I, Damjanov N, Pekmezović T, Sefik-Bukilica M, Antović A. Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis. in Journal of Rheumatology. 2022;49(6):598-606. doi:10.3899/jrheum.210931 .
Colić, Jelena, Pruner, Iva, Damjanov, Nemanja, Pekmezović, Tatjana, Sefik-Bukilica, Mirjana, Antović, Aleksandra, "Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis" in Journal of Rheumatology, 49, no. 6 (2022):598-606, https://doi.org/10.3899/jrheum.210931 . .