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Rotation thromboelastometry and the hypercoagulable state in C ushing's syndrome
Author(s) -
Alves Coelho Maria Caroline,
Vieira Neto Leonardo,
Kasuki Leandro,
Wildemberg Luiz Eduardo,
Santos Camila Vicente,
Castro Gizele,
Gouvêa Glauber,
Veloso Orlando Carlos Gloria,
Gadelha Telma,
Gadelha Mônica R.
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12491
Subject(s) - thromboelastometry , medicine , fibrinogen , von willebrand factor , partial thromboplastin time , deep vein , platelet , clotting time , prothrombin time , coagulation , thrombosis , cardiology , anesthesia , endocrinology
Summary Introduction Rotation thromboelastometry (ROTEM ® ) can be used for hypercoagulability evaluation. Cushing's syndrome (CS) is associated with hypercoagulability; however, ROTEM ® has never been evaluated in this setting. Objective To evaluate hypercoagulability in CS using ROTEM ® and to correlate these parameters with coagulation markers and with the presence of deep vein thrombosis. Design and methods Thirty patients with active CS (26 women) and 30 controls matched for age, sex, body mass index, diabetes mellitus, arterial hypertension, ABO blood group and smoking were included. We measured levels of activated partial thromboplastin time (aPTT), platelets, fibrinogen, D‐dimer, factor VIII (FVIII), von Willebrand factor (vWF) and C‐reactive protein. ROTEM ® was used to evaluate the intrinsic (INTEM), extrinsic (EXTEM) and fibrinogen (FIBTEM) pathways. Doppler ultrasonography was performed to search for lower limbs deep vein thrombosis. Results INTEM clotting time using ROTEM ® was shorter in patients than in controls ( P = 0·04). Other ROTEM ® parameters were not different. Mean aPTT was shorter in patients than in controls ( P = 0·001). The FVIII, vWF and D‐dimer levels were higher in patients than in controls ( P = 0·001, 0·001 and 0·02, respectively). Obese CS patients presented higher levels of platelets and alterations in maximum clot formation (MCF), alpha angle and maximum speed of clot formation of INTEM ( P = 0·03, 0·02 and 0·02, respectively) and an increase in the MCF of FIBTEM ( P = 0·02). No deep vein thrombosis was found. Conclusions Although FVIII and vWF were abnormal in CS patients, only the initiation clot formation was different in the ROTEM ® methodology and no deep vein thrombosis was found.