Protein C, protein S and antithrombin III in children with complicated congenital heart diseases

ABSTRACT

This study was carried out on 40 patients with congenital heart disease [CHD] aged three months to seven years and divided into two groups The first included 28 patients with complicated CHD and the second group included 12 patients with uncomplicated CHD. Ten healthy children were chosen as controls. A coagulation profile consisting of protein C, protein S, antithrombin III, factor V and factor VIII were evaluated in all patients and controls. The mean values of protein C, protein S, antithrombin III, factor V and factor VIII were significantly decreased in patients with complicated CHD compared with both uncomplicated cases and controls. Eighteen out of twenty-two patients with complicated CHD had low protein C levels [2 standard deviations below the normal mean value of the controls]. Of these children, three developed thrombotic complications and eight had evidences suggestive of consumption coagulopathy [decreased factors V and VIII]. It was concluded that decreased levels of coagulation inhibitors protein C, protein S and antithrombin III were observed in ill children with complicated CHD. With reduced levels of protein C, children with complicated CHD might have a tendency toward thrombotic complications