Thromb Haemost 1990; 63(03): 380-382
DOI: 10.1055/s-0038-1645051
Original Article
Schattauer GmbH Stuttgart

Protein C Inhibitor and Other Components of the Protein C Pathway in Patients with Acute Deep Vein Thrombosis during Heparin Treatment

D Tabernero
1  The Department of Hematology, Hospital General, Salamanca, Spain
,
F España
2  The Research Center, Hospital La Fe, Valencia, Spain
,
V Vicente
1  The Department of Hematology, Hospital General, Salamanca, Spain
,
A Estellés
2  The Research Center, Hospital La Fe, Valencia, Spain
,
J Gilabert
3  The Departments of Obstetrics and Gynecology, Hospital La Fe, Valencia, Spain
,
J Aznar
4  The Clinical Pathology, Hospital La Fe, Valencia, Spain
› Author Affiliations
Further Information

Publication History

Received 26 October 1989

Accepted after revision 09 February 1990

Publication Date:
30 June 2018 (online)

Summary

The protein C inhibitor (PCI) concentration and other parameters of the protein C pathway were studied in 19 patients with symptomatic acute deep vein thrombosis before and during the first 5 days of heparin treatment. The mean levels of PCI antigen and activity decreased rapidly and significantly during the first day of heparin therapy from 83 and 81% to 60 and 59% of the pooled normal human plasma (p <0.01), respectively, and to 56 and 54% after 5 days of treatment (p <0.01). In contrast, antithrom-bin III decreased progressively 25% during 5 days of heparin treatment. Protein C antigen and activity and total protein S remained unchanged during heparin treatment. Free protein S was decreased before heparin treatment (83%, p <0.05) and increased to normal values after 5 days of treatment. C4b-binding protein was significantly increased before and during heparin treatment (p <0.01). Activated protein C (APC) complexed to its two major plasma inhibitors, PCI and α1-antitrypsin (α1AT) were measured by specific ELISA’s. Before treatment, 18 of the 19 patients studied had increased levels of APC: α1AT complexes with a mean value of 27 ± 22 ng/ml (range, 6−86 ng/ml) compared to normal values (8 ± 2 ng/ml) and 12 of the patients also had detectable APC:PCI complex levels with a mean value of 11 ±17 ng/ml (range, 5−68 ng/ml). Both APC:inhibitor complexes decreased significantly during heparin treatment.