Hypercoagulability in patients with Cushing disease detected by thrombin generation assay is associated with increased levels of neutrophil extracellular trap-related factors

摘要: Patients with Cushing disease (CD) are at increased risk of venous thromboembolism (VTE). It was surmised, but not conclusively shown that the is related to plasma hypercoagulability secondary glucocorticoids effect. This study aimed detecting in patients CD. Case-control 48 CD and controls enrolled two Italian clinics for whom we assessed thrombin-forming-potential presence optimal activation protein C obtained by adding into assay system its main endothelial activator, thrombomodulin. These experimental conditions mimic more closely than any other test vivo situation. We observed enhanced thrombin-generation patients, as modification parameters [i.e., shortened lag-time time-to-peak, thrombin peak endogenous potential (ETP)]. Moreover, ETP ratio (with/without thrombomodulin), recognized an index hypercoagulability, compared controls. attempted explain such measuring both procoagulant anticoagulant factors, some non-coagulation (i.e., neutrophil extracellular traps (NET), recently associated VTE and/or hypercoagulability. showed levels factor VIII NET-related variables. detected found explanation occurrence. Whether this can entirely occurrence should be investigated ad-hoc clinical trials. However, until these studies will available evidence supports concept candidates antithrombotic prophylaxis.