Hypercoagulability in Cushing's syndrome: the role of specific haemostatic and fibrinolytic markers

Kaštelan, Darko and Dušek, Tina and Kraljević, Ivana and Polašek, Ozren and Giljević, Zlatko and Solak, Mirsala and Zupančić Šalek, Silva and Jelčić, Jozo and Aganović, Izet and Koršić, Mirko (2009) Hypercoagulability in Cushing's syndrome: the role of specific haemostatic and fibrinolytic markers. Endocrine, 36 (1). pp. 70-4. ISSN 1355-008X

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OBJECTIVE: Hypercoagulability is a commonly described complication in patients with Cushing's syndrome. Recent clinical studies have indicated various abnormalities of coagulation and fibrinolysis parameters which may be related to that phenomenon. The aim of this study was to investigate the mechanisms underlying the hypercoagulable state in patients with Cushing's syndrome. ----- RESEARCH METHODS AND PROCEDURES: A wide range of serum markers involved in the processes of blood coagulation and fibrinolysis was measured in a group of 33 patients with Cushing's syndrome and 31 healthy controls. No participant was taking medication which could influence the result or had known diseases, except hypertension and diabetes, which could affect blood coagulation or fibrinolysis parameters. ----- RESULTS: Patients with Cushing's syndrome had higher levels of clotting factors II (P = 0.003), V (P < 0.001), VIII (P < 0.001), IX (P < 0.001), XI (P < 0.001) and XII (P = 0.019), protein C (P < 0.001), protein S (P < 0.001), C1-inhibitor (P < 0.001) and plasminogen activator inhibitor-1 (PAI-1) (P = 0.004). The activity of fibrinolytic markers, plasminogen (P < 0.001), antithrombin (P < 0.001) and antithrombin antigen (P = 0.001) was also increased in the patient group. ----- CONCLUSION: The study has demonstrated hypercoagulability in patients with Cushing's syndrome manifest as increased prothrombotic activity and compensatory activation of the fibrinolytic system. We propose the introduction of thromboprophylaxis in the preoperative and early postoperative periods, combined with a close follow-up in order to prevent possible thromboembolic events in patients with Cushing's syndrome.

Item Type: Article
MeSH: Adult ; Aged ; Aged, 80 and over ; Biological Markers/blood ; Blood Coagulation Factors/metabolism ; Blood Coagulation Tests ; Cushing Syndrome/blood ; Cushing Syndrome/complications ; Fibrinolysis/physiology ; Hemostasis/physiology ; Humans ; Middle Aged ; Thrombophilia/blood ; Thrombophilia/etiology ; Thrombosis/blood ; Thrombosis/etiology Young Adult
Departments: Katedra za internu medicinu
Katedra za medicinsku statistiku, epidemiologiju i medicinsku informatiku
Depositing User: Marijan Šember
Status: Published
Kaštelan, DarkoUNSPECIFIED
Kraljević, IvanaUNSPECIFIED
Giljević, ZlatkoUNSPECIFIED
Zupančić Šalek, SilvaUNSPECIFIED
Date: August 2009
Date Deposited: 28 Oct 2010
Last Modified: 23 Sep 2011 16:11
Subjects: /
Related URLs:
    URI: http://medlib.mef.hr/id/eprint/874

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