exudates and Thrombophilia

Various factors may contribute to a hypercoagulable state and acute vascular thrombosis. A prospective study was conducted involving 165 coronary heart disease (CHD) patients from the Cardiology Unit, Hospital Universiti Sains Malaysia. The purpose of this study was to investigate the relationship among factor VIII (FVIII), prothrombin time (PT), activated partial thromboplastin time (APTT), and activated protein C resistance (APC-R) state among CHD patients and to look for potential clinical applications from these laboratory findings. There were 110 cases diagnosed as acute coronary syndrome (ACS), whereas another 55 were stable coronary artery disease (SCAD) patients. PT, APTT, FVIII, and APC-R assays were performed on all subjects. There was a significant difference between the FVIII level and the APTT results (P value < 0.0001). A negative relationship was found between the FVIII level and the APTT from linear regression analysis (R(2) = 10%, P value < 0.0001). For each 1% increase in the FVIII level, the APTT was reduced by 0.013 s (95% confidence interval (CI) between -0.019 and -0.007). Interestingly, none of the SCAD patients had abnormally short APTT. Approximately 68.4% of cases with a positive APC-R assay were found to have a high FVIII level. In conclusion, the APTT test is a potential hemostatic marker for hypercoagulable state including in arterial thrombosis.

Topics: Acute Disease; Biomarkers; Coronary Disease; Cross-Sectional Studies; Factor VIII; Hemostasis; Humans; Malaysia; Outpatients; Partial Thromboplastin Time; Prospective Studies; Protein C; Prothrombin Time; Thrombophilia; Time Factors

The status of thrombophilia in Asian women with recurrent pregnancy loss (RPL) is obscure and poorly understood. Numerous studies suggest the non-existence or extreme rarity of the two important thrombophilia markers, factor V Leiden (FVL) and prothrombin G20210A (PTG) mutations, in patients of Asian ancestries. Thus, the consensus that thrombophilia is rare among Asians and laboratory investigations is irrelevant. We therefore investigated Malaysian women with RPL for thrombophilia abnormalities.. A total of 402 patients (RPL subjects) and 160 female controls were screened for FVL, PTG and methylene tetrahydrofolate reductase mutations using polymerase chain reaction, activated protein C resistance (APC-R) using clot-based tests, protein C and antithrombin using chromogenic tests, and protein S and antiphospholipid antibodies using enzyme-linked immunosorbent assays.. APC-R was identified in 21.6% (87/402) of the RPL subjects. Of the 87 APC-R positive RPL subjects, 9.2% (8/87) were due to FVL, 51.7% (45/87) had protein S deficiency, 6.9% (6/87) had protein C deficiency, 6.9% (6/87) had combined protein S and protein C deficiencies, 1.1% (1/87) had antithrombin deficiency and 25.3% (22/87) had unidentifiable non-specific abnormalities. Antiphospholipid antibodies were identified in 4.2% (17/402) of the RPL subjects. FVL (2% = 8/402) and PTG (0.5% = 2/402) were identified in the Malay and Indian RPL subjects, but there were none in the Chinese subjects or the controls. Methylene tetrahydrofolate reductase was identified in 35.3% (142/402) of the RPL subjects.. Thrombophilia was identified in more than one-quarter (26.6% = 107/402) of the RPL subjects. APC-R not caused by FVL mutation was the most common thrombophilia marker in Malaysians, whereas in Caucasians it was the APC-R due to FVL mutation. The identification of FVL and PTG mutations in Malaysian women with RPL disputes prevailing evidences suggesting its non-occurrence in patients with Asian ancestries.

Topics: Abortion, Habitual; Adult; Female; Humans; Malaysia; Middle Aged; Pregnancy; Thrombophilia; Young Adult

The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti-thrombin in pre-eclampsia and pregnancy-induced hypertensive patients.. Blood samples were collected from a total number of 124 women at the maternity unit, University of Malaya Medical Center. These included 49 patients with pre-eclampsia, 63 patients with pregnancy-induced hypertension and 12 normal pregnant women. DNA was extracted from the blood samples. Factor V Leiden (Taq I) and prothrombin G20210A (Hind III) genotyping was done on polymerase chain reaction-restriction fragment length polymorphism. Anti-thrombin activity and the concentrations of protein C, protein S and activated protein C were measured using the IL Coagulation System (Hemosil).. Of the 124 subjects, one pre-eclampsia patient was homozygous for Factor V Leiden mutation but prothrombin G20210A mutation was not present in any of the subjects. The subject with Factor V Leiden mutation also had a low activated protein C resistance and a low protein S concentration.. Factor V Leiden mutation is present in the Asian population and may very well serve as one of the genetic factors responsible for pre-eclampsia and other adverse pregnancy outcomes.

Topics: DNA; Factor V; Female; Genetic Markers; Humans; Hypertension, Pregnancy-Induced; Malaysia; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Pre-Eclampsia; Pregnancy; Protein C; Protein S; Prothrombin; Thrombophilia

Topics: Adult; Biomarkers; Female; Fetal Death; Humans; Malaysia; Pregnancy; Pregnancy Complications, Hematologic; Prevalence; Recurrence; Thrombophilia