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Title: Fibrin clot properties and their determinants in patients with aortic stenosis


The main goal of the project was to comprehensively assess the phenotype of fibrin clots and identify new factors responsible for the decreased efficiency of fibrinolysis in patients with aortic stenosis (AS). In article 1, the comparison of three assays that are now commonly used to evaluate fibrinolytic capacity in citrate plasma was performed. The impact of sociodemographic and laboratory factors on the fibrinolytic efficiency was assessed with the methods. Additionally, the strongest determinants for prolonged lysis times were determined. The study provided evidence for significant differences among fibrinolysis assays in terms of demographic and laboratory determinants. In article 2, the impact of elevated oxidative stress was evaluated regarding the AS progression and fibrinolytic disorders. For this purpose, levels of global oxidation blood markers, as well as fibrinolytic efficiency, were determined. It has been shown that higher levels of oxidative stress, expressed by oxidation markers, was associated with reduced fibrinolytic efficiency and disease severity in patients with isolated AS. Patients with the highest levels of oxidation stress were characterized by the fibrin composed of thinner fibrin fibers that formed a denser and less lysable clots as compared with the remaining patients. Moreover, oxidation markers have been significant determinants of decreased ef ; ficiency of fibrinolysis. In article 3, the associations of lipids, their protein components (apolipoproteins) and their oxidation on the phenotype of fibrin clots were analyzed. Oxidized low-density lipoproteins (Ox-LDL) as well as apolipoproteins have been shown to be stronger predictors of prolonged clot lysis time in comparison with serum lipoproteins. Additionally, patients who use statins had shorter lysis times and lower serum Ox-LDL, suggesting a positive effect of lipid-lowering agents on oxidative stress and fibrinolysis in patients with severe AS. Additionally, increased Lp (a) level has been associated with decreased fibrinolytic capacity. Given the use of different assays for measuring fibrinolytic capacity in various disease states, it is possible to choose the assay most appropriate for the particular clinical setting. Moreover, chose at least two different assays could provide better characteristics of fibrinolytic capacity in a specific patient group. In AS patients global higher oxidation stress contribute to more impaired fibrinolysis, altered fibrin clot structure, and ultimately to the progression of AS. Moreover, dyslipidemia along with increased amounts of apolipoproteins, Ox-LDL, and Lp (a) contribute to prothrombotic fibrin clot properties, in particular impaired global fibrinolysis in AS patients.

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Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu krążenia

Degree grantor:

Rada Dyscypliny Nauki medyczne


Undas, Anetta

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pol; eng

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tylko w bibliotece

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Last modified:

Apr 8, 2024

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Jan 23, 2023

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ZB-135524 Apr 8, 2024


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