IS THERE ANY CORRELATION BETWEEN FIBRINOLYTIC ACTIVITY AND BLEEDING SCORE IN TYPE 1 AND POSSIBLE TYPE 1 VON WILLEBRAND DISEASE?

WOODS AI; SÁNCHEZ-LUCEROS A; BLANCO AN; GROSSO S; KEMPFER AC; LAZZARI MA

Suiza

Congreso; XXIst Congress of the International Society on Thrombosis and Haemostasis; 2007

International Society of Thrombosis and Haemostasis

Introduction: DDAVP is the main treatment in most of VWD patients (pts), with fibrinolytic inhibitors indicated as complementary prophylaxis in some cases. Our purpose was to evaluate the changes in plasmatic fibrinolytic activity induced by DDAVP infusion at age over 18 years, and to correlate these changes with the bleeding score (BS), in 60 type 1 and 278 possible type 1 VWD pts. Methods: BS, number of bleeding sites and euglobulin lysis time (ELT) data were collected from clinical histories of pts. The factor levels were comparable in type 1 and possible type 1 before and after 1 hour DDAVP infusion (i.v. 0.3 ug/kg). Pts were grouped according to the number of bleeding sites (<3 sites: group A, >=3 sites: group B) and ELT post-DDAVP (abnormal: <=30 minutes). Results: Group A Type 1: pts with abnormal ELT post-DDAVP (n=5) showed BS=1.2 0.9 and ELT pre DDAVP=146.086.4 min; pts with normal ELT post-DDAVP (n=19) showed BS=1.7 0.6 and ELT pre-DDAVP=153.255.5 min (p=ns). Possible type 1: pts with abnormal ELT post-DDAVP (n=16) showed BS=1.61.1 and ELT pre-DDAVP=140.349.1 min; pts with normal ELT post-DDAVP (n=125) showed BS=1.7 1.0 and ELT pre-DDAVP=216.254.0 min (p=ns). Group B Type 1: pts with abnormal ELT post-DDAVP (n=5) showed BS=5.03.5 and ELT pre-DDAVP=164.0111.5 min; pts with normal ELT post-DDAVP (n=32) showed BS=4.5 1.4 and ELT pre-DDAVP=158.254.9 min (p=ns). Possible Type 1: pts with abnormal ELT post-DDAVP (n=18) showed BS=4.21.4 and ELT pre-DDAVP=169.451.3 min; pts with normal ELT post-DDAVP (n=119) showed BS=4.3 1.4 and ELT pre-DDAVP=208.569.4 min (p=ns). Conclusions: Conclusion: No correlation was observed between the BS and ELT before and post-DDAVP infusion. This fibrinolytic parameter either before or after DDAVP infusion is not useful marker to identify VWD patients with higher bleeding risk under a challenge.In addition, it appears not to influence on the BS of VWD pts.