Key result
Elevated plasma protein carbonylation linked to ~6-fold higher odds of prolonged clot lysis in isolated AS.
Why the study?
Aortic stenosis has been associated with impaired fibrinolysis and increased oxidative stress, but the relationship between oxidative stress and fibrin clot properties in AS was unclear.
Observational (n=173)
Odds Ratio: 6.41 (95% CI 2.58–17.83)
p-value: p=<0.001
Elevated oxidative stress, particularly protein carbonylation, is associated with impaired fibrinolysis and disease severity in patients with isolated aortic stenosis.
Should not yet change aortic stenosis management; hypothesis-generating for oxidative stress in impaired fibrinolysis.
Aortic stenosis (AS) has been associated with impaired fibrinolysis and increased oxidative stress. This study aimed to investigate whether oxidative stress could alter fibrin clot properties in AS. We studied 173 non-diabetic patients, aged 51–79 years, with isolated AS. We measured plasma protein carbonylation (PC) and thiobarbituric acid reactive substances (TBARS), along with plasma clot permeability (Ks), thrombin generation, and fibrinolytic efficiency, which were evaluated by two assays: clot lysis time (CLT) and lysis time (Lys50). Coagulation factors and fibrinolytic proteins were also determined. Plasma PC showed an association with AS severity, reflected by the aortic valve area and the mean and maximum aortic gradients. Plasma PC was positively correlated with CLT, Lys50, plasminogen activator inhibitor-1 (PAI-1), and tissue factor (TF) antigens. TBARS were positively correlated with maximum aortic gradient, Lys50, and TF antigen. Regression analysis showed that PC predicted prolonged CLT (>104 min; odds ratio (OR) 6.41, 95% confidence interval (CI) 2.58–17.83, p < 0.001) and Lys50 (>565 s; OR 5.83, 95% CI 2.23–15.21, p < 0.001). Multivariate regression analysis showed that mean aortic gradient, PC, α2-antiplasmin, PAI-1, and triglycerides were predictors of prolonged CLT, while PC, α2-antiplasmin, and fibrinogen were predictors of Lys50. Our findings suggest that elevated oxidative stress contributes to impaired fibrinolysis in AS and is associated with AS severity.
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Siudut et al. (2020) conducted an observational in Isolated aortic stenosis (n=173). Elevated oxidative stress (plasma protein carbonylation) was evaluated on Prolonged clot lysis time (>104 min) (OR 6.41, 95% CI 2.58-17.83, p=<0.001). Elevated plasma protein carbonylation predicted prolonged clot lysis time (OR 6.41; 95% CI 2.58-17.83; p<0.001) in patients with isolated aortic stenosis.
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