Estado protrombótico en estadios tempranos de la enfermedad de Chagas crónica

Background. Thromboembolic complications are frequent in advanced Chagas’ disease. Objective. This study was designed to explore the presence of a prothrombotic state in the early stages of chronic Chagas’ disease by evaluating serum markers of thrombosis and fibrinolysis. Patients and method. Forty-two patients with chronic Chagas’ disease (12 men and 30 women, 32.5 ± 6.7 years) were compared with 21 healthy volunteers (10 men and 11 women, 24.2 ± 5.6 years). The markers of thrombotic activation used were fragment 1 + 2, ATM complex, PDF/pdf, D-dimer, and β-thromboglobulin. Fibrinolysis was evaluated before and after venous occlusion, together with euglobulin lysis time, t-PA, and PAI-1 titers. Results. The markers of thrombotic state were significantly higher in patients with chronic Chagas’ disease than in controls: F1 + 2 (p < 0.0001), ATM (p < 0.0001), PDF/pdf (p < 0.05), and D dimer (p < 0.05). There was no significant difference in β-thromboglobulin (p = 0.06). Euglobulin lysis time, a global fibrinolytic marker, differed significantly (p < 0.0001) between patients with Chagas’ disease and healthy volunteers. However, the more specific fibrinolytic markers t-PA and PAI-1 did not differ significantly between the two study groups. Conclusions. Although there were no significant differences in fibrinolytic markers between patients with chronic Chagas’ disease and healthy volunteers, the significant increase in thrombosis markers (F1 + 2, ATM complex, PDF/pdf, and D dimer) suggests the presence of a prothrombotic state in the early stages of chronic Chagas’ disease.