Tuesday, July 30, 2013

Hipercoagulabilidade em gatos com miocardiopatia / Hypercoagulability in cats with cardiomyopathy

Hypercoagulability in Cats with Cardiomyopathy

  1. T. Stokol1
  2. M. Brooks1
  3. J.E. Rush3
  4. M. Rishniw2
  5. H. Erb1
  6. E. Rozanski3
  7. M.S. Kraus2
  8. A.L. Gelzer2
Article first published online: 10 JUL 2008
DOI: 10.1111/j.1939-1676.2008.0098.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 22Issue 3pages 546–552May–June 2008


  • Aortic thromboembolism;
  • d-dimer;
  • Endothelial injury;
  • Hemostasis;
  • Spontaneous echocardiographic contrast;
  • Thrombin-antithrombin complexes
Background: Arterial thromboembolism (ATE) is a common complication of feline cardiomyopathy; however, the pathogenesis of ATE is unknown.
Hypothesis: Systemic activation of the coagulation cascade (hypercoagulability) and endothelial injury promote ATE in cardiomyopathic cats.
Animals: Healthy cats (n = 30) and 3 groups of cardiomyopathic cats: Group (1) left atrial enlargement only (LAE [n = 11]), ie, left atrial to aortic ratio >1.4; Group (2) LAE with spontaneous echocardiographic contrast, atrial thrombi or both (SEC-T [n = 16]); and Group (3) acute ATE with LAE (n = 16).
Methods: Hypercoagulability was defined by 2 or more laboratory abnormalities reflecting coagulation factor excess (high fibrinogen concentration or Factor VIII coagulant activity), inhibitor deficiency (low antithrombin activity), or thrombin generation (high thrombin-antithrombin complex [TAT] and d-dimer concentrations). High von Willebrand factor antigen concentration (vWF : Ag) was considered a marker of endothelial injury. Data were analyzed using nonparametric statistics.
Results: The 3 groups of cats with cardiac disease had higher median fibrinogen concentrations than did the healthy cats. Criteria of hypercoagulability were found exclusively in cats with SEC-T (50%) and ATE (56%). Hypercoagulability was not associated with left atrial size or congestive heart failure (CHF). ATE cats had significantly higher median vWF : Ag concentration than did the other groups.
Conclusinos and Clinical Importance: Systemic hypercoagulability is evident in many cardiomyopathic cats, often without concurrent CHF or overt ATE. Hypercoagulabilty may represent a risk factor for ATE. High vWF : Ag in ATE cats was attributed to downstream endothelial injury from the occlusive thrombus.

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