Ramberg Cathrine, Wilsgård Line, Latysheva Nadezhda, Brækkan Sigrid K, Hindberg Kristian, Sovershaev Timofey, Snir Omri, Hansen John-Bjarne
Thrombosis Research Centre (TREC) Department of Clinical Medicine UiT - The Arctic University of Norway Tromsø Norway.
Division of Internal Medicine University Hospital of North Norway Tromsø Norway.
Res Pract Thromb Haemost. 2021 Dec 20;5(8):e12640. doi: 10.1002/rth2.12640. eCollection 2021 Dec.
Negatively charged procoagulant phospholipids, phosphatidylserine (PS) in particular, are vital to coagulation and expressed on the surface membrane of extracellular vesicles. No previous study has investigated the association between plasma procoagulant phospholipid clotting time (PPL) and future risk of venous thromboembolism (VTE).
To investigate the association between plasma PPL and the risk of incident VTE in a nested case-control study.
We conducted a nested case-control study in 296 VTE patients and 674 age- and sex-matched controls derived from a general population cohort (The Tromsø Study 1994-2007). PPL was measured in platelet-free plasma using a modified factor Xa-dependent clotting assay. Logistic regression was used to estimate odds ratio (OR) with 95% confidence intervals (CI) for VTE with PPL modelled as a continuous variable across quartiles and in dichotomized analyses.
There was a weak inverse association between plasma PPL and risk of VTE per 1 standard deviation increase of PPL (OR 0.93, 95% CI 0.80-1.07) and when comparing those with PPL in the highest quartile (OR 0.89, 95% CI 0.60-1.30) with those in the lowest quartile. Subjects with PPL >95th percentile had substantially lowered OR for VTE (OR 0.35, 95% CI 0.13-0.81). The inverse association was stronger when the analyses were restricted to samples taken shortly before the event. The risk estimates by categories of plasma PPL were similar for deep vein thrombosis and pulmonary embolism.
Our findings suggest that high plasma PPL is associated with reduced risk of VTE.
带负电荷的促凝磷脂，尤其是磷脂酰丝氨酸（PS），对凝血至关重要，并在细胞外囊泡的表面膜上表达。此前尚无研究调查血浆促凝磷脂凝血时间（PPL）与未来静脉血栓栓塞（VTE）风险之间的关联。
在一项巢式病例对照研究中调查血浆PPL与VTE发病风险之间的关联。
我们在296例VTE患者和674例年龄及性别匹配的对照中进行了一项巢式病例对照研究，这些对照来自一个普通人群队列（特罗姆瑟研究，1994 - 2007年）。使用改良的依赖因子Xa的凝血测定法在无血小板血浆中测量PPL。采用逻辑回归估计VTE的比值比（OR）及95%置信区间（CI），将PPL作为连续变量在四分位数中建模，并进行二分分析。
血浆PPL每增加1个标准差，与VTE风险之间存在微弱的负相关（OR 0.93，95% CI 0.80 - 1.07），并且在将PPL处于最高四分位数的人群与最低四分位数的人群进行比较时也是如此（OR 0.89，95% CI 0.60 - 1.30）。PPL>第95百分位数的受试者VTE的OR显著降低（OR 0.35，95% CI 0.13 - 0.81）。当分析仅限于事件发生前不久采集的样本时，这种负相关更强。深静脉血栓形成和肺栓塞的血浆PPL类别风险估计相似。
我们的研究结果表明，高血浆PPL与降低的VTE风险相关。
