ABSTRACT
Cancer-associated thrombosis (CAT) is a leading cause of mortality in cancer patients and its incidence varies in different parts of the world. Venous thromboembolism (VTE) is a prominent manifestation of CAT, and significantly impacts morbidity and survival compared to arterial thrombosis in cancer patients. Several risk factors for developing VTE such as chemotherapy and immobilization have also been found co-existing with cancer patients and contributing to the increased risk of VTE in cancer patients than in non-cancer patients. This review highlights recent mechanisms in the pathogenesis of hypercoagulable syndromes associated with cancer, multiple mechanisms implicated in promoting cancer-associated thrombosis and their diagnostic approaches. Cancer cells interact with every part of the hemostatic system; generating their own procoagulant factors, through stimulation of the prothrombotic properties of other blood cell components or the initiation of clotting by cancer therapies which can all directly activate the coagulation cascade and contribute to the VTE experienced in CAT. It is our hope that the multiple interconnections between the hemostatic system and cancer biology and the improved biomarkers reported in this study can be relevant in establishing a predictive model for VTE, optimize early detection of asymptomatic microthrombosis for more personalized prophylactic strategies and incorporate effective therapeutic options and patient management to reduce mortality and morbidity, and improve the quality of life of affected cancer patients.
ABSTRACT
Fibrinogen, one of the most hemorheologically active plasma proteins, is associated with several cardiovascular risk factors, and the plasma concentration can alter dramatically during acute phase response and in a wide variety of clinical conditions. We have assessed fibrinogen levels in some known cardiovascular disorders, during usage of contraceptive pills, acute phase conditions and pregnancy. Our results from patients with various disease conditions indicate that fibrinogen levels are in the pathological range and are significantly higher than in healthy controls (p<0.001). It is concluded that although Africans have low predisposition to thrombosis, they may well be pre-disposed to abnormal fibrin formation which could lead to various thromboembolic complications.
ABSTRACT
Differences in haemostatic parameters have been reported among smokers and non-smokers. However the relationships of these parameters with other risk factors of cardiovascular diseases have not been fully determined in Nigerians. We therefore aimed at assessing the relationship between fibrinogen, factor VII (FVII), age, body mass indeks (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in smokers and non-smokers living in an Urban Nigerian city. We studied 104 male Nigerians grouped into non-smokers (n= 74) and smokers (n= 30). Fibrinogen was measured using the clot weight method of Ingram and FVII was assayed by the bioassay method. Mean fibrinogen and FVII were found to be higher in smokers than non-smokers. There was no relationship between FVII and age (r= -0.0458) in non-smokers and a weak association was found between FVII and age in smokers (r= 0.3191). Both SBP and DBP were significantly associated with BMI in smokers (r= 0.6332, p= 0.0002) for DBP and (r= 0.4869, p= 0.0064) for SBP. Fibrinogen was only associated with DBP in non-smokers (r= 0.3273, p= 0.0047). FVII and fibrinogen were found to be higher in smokers compared to non- smokers, the difference was not statistically significant (p= 0.1965). The strength of the association of BMI and fibrinogen with blood pressure is higher for DBP in Nigerians. Extensive population studies should be conducted on smokers and non-smokers to confirm these associations.
