Summary
The role of plasminogen (plg) deficiency in the pathogenesis of venous thromboembolism
is debated in the literature. In the present study we evaluated the prevalence of
plg deficiency in our thrombophilia patients and aimed to elucidate the thrombosis
risk of plg deficiency as a single defect or in combination with other defects, with
special focus on APC resistance.
The study cohort included 1192 consecutive patients with a history of clinically or
objectively diagnosed venous and/or arterial thromboembolism and/or positive family
history who were referred to our department for thrombophilia investigation from 02/1988
to 03/1997. All available family members of patients with plg deficiency were tested
for plg, APC resistance and other thrombophilic defects that were established in the
propositus.
23/1192 propositi were plg-deficient corresponding to an overall prevalence of 1.9%,
i.e. 2.2% in patients with venous thrombosis and 1.4% in those with arterial events.
Out of the 23 plg-deficient propositi, 8 showed one or multiple additional thrombophilic
defects, and in 4 patients relevant circumstantial risk factors were present. Of the
53 available family members, 28 were plg-deficient including 5 with additional APC
resistance, and 4 subjects had isolated APC resistance. Ten of the 53 family members
had already suffered thromboembolic events, i.e. 5 (18%) in the plg-deficient group
and 5 (20%) in the non-deficient group, both groups showing an almost identical median
age at the time of investigation (28.9 years and 27.1 years, respectively).
Based on our data, plg deficiency is a rare defect in thrombophilic patients and as
a single defect it does not seem to be a strong thrombotic risk factor, as 11 of 23
propositi had additional thrombophilic defects or circumstantial risk factors, and
in the family members thrombotic events were equally frequent in the plg-deficient
and non-deficient subjects.
