{"doi":"10.20452/pamw.17140","title":"Altered fibrin clot properties and the risk of thromboembolism in women with obstetric antiphospholipid syndrome: a cohort study","abstract":"INTRODUCTION: Formation of denser and poorly lysable fibrin clots has been reported in thrombotic antiphospholipid syndrome (APS). However, it is not known whether unfavorably altered fibrin clot properties and suppressed fibrinolysis characterize women with obstetric APS (OAPS) free of thromboembolic events (TEs). OBJECTIVES: This study sought to investigate fibrin clot characteristics and if they predict TE in women with OAPS. PATIENTS AND METHODS: In 62 women with OAPS and 62 controls, we determined plasma fibrin clot properties, including permeability (Ks) and clot lysis time (CLT), along with the levels of thrombin activatable fibrinolysis inhibitor (TAFI), plasminogen activator inhibitor‑1 (PAI‑1), plasminogen, and endogenous thrombin potential (ETP). TEs were recorded during median (interquartile range) follow‑up of 54 (49-58) months. RESULTS: The patients with OAPS had lower Ks (by 16.4%) and longer CLT (by 16.9%), with slightly higher ETP (by 4.2%), higher TAFI antigen level (by 15.6%), lower plasminogen level (by 7.9%), and similar PAI‑1 antigen level, as compared with controls (all P <0.05). The patients with high‑risk OAPS (n = 47; 75.8%) and positive for lupus anticoagulant (LA) had lower Ks and longer CLT than the low‑risk and LA‑negative individuals. There were no differences in fibrin clot properties and ETP between the patients positive for a single antiphospholipid antibody and controls. During follow‑up, higher odds of developing TEs were observed in the patients with OAPS (adjusted odds ratio, 5.26; 95% CI, 1.27-21.87), and those with OAPS who experienced a TE (16.1%; 2.2/year) had lower baseline Ks (by 17.5%) and longer CLT (by 12.2; both P <0.05). Reduced Ks (≤6.1 × 10‑9 cm2) predicted TE in the patients with OAPS. CONCLUSIONS: Prothrombotic fibrin clot properties characterize the patients with OAPS, which may increase the risk of TEs.","journal":"Polskie Archiwum Medycyny Wewnętrznej","year":2025,"id":542499,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9641,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":898612,"name":"Michał Ząbczyk","orcid":"0000-0003-1762-308X","position":1,"is_corresponding":false},{"id":1431536,"name":"Joanna Natorska","orcid":"0000-0003-3176-8007","position":2,"is_corresponding":false},{"id":1432073,"name":"Robert Jach","orcid":null,"position":3,"is_corresponding":false},{"id":375001,"name":"Saulius Butenas","orcid":null,"position":4,"is_corresponding":false},{"id":379234,"name":"Anetta Undas","orcid":"0000-0002-0667-8109","position":5,"is_corresponding":false},{"id":1431535,"name":"Magdalena Piróg","orcid":"0000-0002-1764-0747","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:52:55.809501Z","pmid":"41117585","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}