TY - JOUR
T1 - The procoagulant potential before and after surgery for endometriosis and its association with disease severity
AU - Rottenstreich, Amihai
AU - Kalish, Yosef
AU - Gilan, Adi
AU - Spectre, Galia
AU - Kleinstern, Geffen
AU - Dior, Uri
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - ObjectivesPrevious studies have suggested that endometriosis is associated with increased hypercoagulable state. We aimed to determine the procoagulant potential among women with endometriosis before and after surgery.MethodsA prospective longitudinal study performed during 2020-2021 at a university hospital. Women undergoing laparoscopic surgery for endometriosis served as the study group. Blood samples were taken preoperatively and 3months after surgery. The degree of hypercoagulability was assessed by thrombin generation, a global marker of the activation of the coagulation system, expressed as the endogenous thrombin potential (ETP). Healthy volunteers, without any medical condition or medications use, matched for age and weight of the study group, served as a control group.ResultsThirty women with histologically-proven endometriosis and thirty healthy control subjects were enrolled in this study. Median preoperative ETP was significantly higher in women with moderate-To-severe endometriosis (3313 [interquartile range, IQR 3067-3632] nM) as compared to those with minimal-To-mild disease (2368 [IQR 1850-2621] nM) and the control group (2451 [2096-2617] nM) (P<0.001 for both comparisons). Following surgery, the ETP significantly decreased in those with moderate-To-severe endometriosis (postoperative: 2368 vs. preoperative: 3313nM, P<0.001) and was comparable to the ETP in the control group (P=0.35). In multivariate analysis, moderate-To-severe endometriosis was the only independent predictor of the preoperative ETP level (P<0.001), with a direct positive correlation between disease revised American Society for Reproductive Medicine severity score and the preoperative ETP level (rs=0.67; P<0.0001).ConclusionModerate-To-severe endometriosis is associated with enhanced hypercoagulable state, which decreases significantly after surgery. Disease severity was independently associated with the degree of hypercoagulability.
AB - ObjectivesPrevious studies have suggested that endometriosis is associated with increased hypercoagulable state. We aimed to determine the procoagulant potential among women with endometriosis before and after surgery.MethodsA prospective longitudinal study performed during 2020-2021 at a university hospital. Women undergoing laparoscopic surgery for endometriosis served as the study group. Blood samples were taken preoperatively and 3months after surgery. The degree of hypercoagulability was assessed by thrombin generation, a global marker of the activation of the coagulation system, expressed as the endogenous thrombin potential (ETP). Healthy volunteers, without any medical condition or medications use, matched for age and weight of the study group, served as a control group.ResultsThirty women with histologically-proven endometriosis and thirty healthy control subjects were enrolled in this study. Median preoperative ETP was significantly higher in women with moderate-To-severe endometriosis (3313 [interquartile range, IQR 3067-3632] nM) as compared to those with minimal-To-mild disease (2368 [IQR 1850-2621] nM) and the control group (2451 [2096-2617] nM) (P<0.001 for both comparisons). Following surgery, the ETP significantly decreased in those with moderate-To-severe endometriosis (postoperative: 2368 vs. preoperative: 3313nM, P<0.001) and was comparable to the ETP in the control group (P=0.35). In multivariate analysis, moderate-To-severe endometriosis was the only independent predictor of the preoperative ETP level (P<0.001), with a direct positive correlation between disease revised American Society for Reproductive Medicine severity score and the preoperative ETP level (rs=0.67; P<0.0001).ConclusionModerate-To-severe endometriosis is associated with enhanced hypercoagulable state, which decreases significantly after surgery. Disease severity was independently associated with the degree of hypercoagulability.
KW - disease severity
KW - endometriosis
KW - hypercoagulability
KW - procoagulant potential
KW - thrombin generation
UR - http://www.scopus.com/inward/record.url?scp=85164292830&partnerID=8YFLogxK
U2 - 10.1097/MBC.0000000000001228
DO - 10.1097/MBC.0000000000001228
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 37395195
AN - SCOPUS:85164292830
SN - 0957-5235
VL - 34
SP - 305
EP - 309
JO - Blood Coagulation and Fibrinolysis
JF - Blood Coagulation and Fibrinolysis
IS - 5
ER -