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Diminished global fibrinolytic capacity in patients with mitral valve prolapse is associated with transient ischemic
Enver Atalar1, Tayfun Açil, Kudret Aytemir
1Hacettepe University School of Medicine, Cardiology Department, Ankara, Turkey. eatalar@lycos.com
Abstract:
Although mitral valve prolapse (MVP) has shown to be associated with thromboembolic complications, the cause of thromboembolic events in those patients is still unknown. The purpose of this study was to evaluate the fibrinolytic activity in MVP patients. The study included 35 consecutive patients (25 women, mean age 25+/-11 years) with echocardiographically documented MVP and 25 age- and sex-matched subjects as a control group. Four of MVP patients have a history of transient ischemic attack (TIA). Global fibrinolytic capacity (GFC), a new technique that examines the effectiveness of the entire fibrinolytic system, was measured. Global fibrinolytic capacity was found to be nonsignificantly increased in MVP patients (3.14+/-1.42 microg/mL) compared to those in control subjects (2.36+/-1.33 microg/mL) (p>0.05). However, in four of these MVP patients who had a history of transient ischemic attack, the GFC level was significantly lower than in patients who have no history of transient ischemic attack (1.67+/-0.6 microg/mL vs 3.27+/-1.46 (microg/mL, p=0.003). Furthermore, the GFC levels of these four patients were less than those of controls (p=0.04). These results showed that global fibrinolytic activity was similar in MVP patients without a history of TIA and control subjects. However, MVP patients with a history of TIA had significantly decreased global fibrinolytic activity compared to controls and as well as MVP patients without a history of TIA.
Insights
Mitral valve prolapse (MVP) patients generally have normal fibrinolytic activity. However, MVP patients with a history of transient ischemic attack (TIA) exhibit significantly reduced fibrinolytic capacity, suggesting a potential link to stroke risk.
Area of Science:
- Cardiology
- Hematology
- Thrombosis Research
Background:
- Mitral valve prolapse (MVP) is linked to thromboembolic complications, but the underlying mechanisms remain unclear.
- Evaluating fibrinolytic activity is crucial for understanding thrombotic risk in MVP patients.
Purpose of the Study:
- To assess global fibrinolytic capacity (GFC) in patients with mitral valve prolapse.
- To investigate potential differences in fibrinolysis between MVP patients with and without a history of transient ischemic attack (TIA).
Main Methods:
- Compared GFC in 35 MVP patients and 25 healthy controls using a novel technique.
- Stratified MVP patients based on history of TIA to analyze GFC levels.
Main Results:
- Overall GFC was not significantly different between MVP patients and controls.
- MVP patients with a history of TIA showed significantly lower GFC compared to both controls and MVP patients without TIA history.
- GFC levels in MVP patients with TIA history were below control levels.
Conclusions:
- Global fibrinolytic activity is comparable in MVP patients without TIA and controls.
- Reduced global fibrinolytic activity in MVP patients with TIA history may indicate an increased risk for thromboembolic events.
- Further research is warranted to explore the role of impaired fibrinolysis in MVP-associated cerebrovascular events.