INTEREST OF THE RATIO OF INCREASE OF (β-THROMBOGLOBULIN (Δ+/βTG) AND OF FIBRINOPEPTIDE A (Δ+ FPA) FOR DIAGNOSIS AND TREATMENT OF THR0MB0-EMB0LIC DISEASES
The interest of release of TG and FPA for the diagnosis and treatment of prethrombotic and thrombotic disorders is well knownThe ratio of increase of these two parameters (Δ+βTG/+ FPA) seems to bring some additional informations.This ratio, normally about 1, increases in isolated or preponderant platelet activation and decreases when platelet activation plays a minor role than the plasmatic factors. A more logical choice of therapeutics and a better control of its effectiveness are so possible.This study includes 91 cases of established thrombosis (20 arterial and 71 venous) and 272 cases of prethrombotic disorders (58 Raynaud syndromes, 54 cases of venous insufficiency, 60 of hip prosthesis, 40 of coronary by-pass, 60 of valvular replacement). The ratio + TG/ + FPA was calculated before, during and after efficacious or inefficacious treatment. In the cases of established thrombosis, our results confirm the leading role of platelets in the development of arterial thrombosis. The cases of venous thrombosis may be divided in two groups : simple venous thrombosis when the plasmatic factors play a leading role and complicated or recurrent venous thrombosis where the platelets play an equivalent or even a greater role.In the cases of prethrombotic states, the role of the platelets which is important on the arterial side is generally far from negligeable on the venous side. In cases of valvular replacement or of coronary by-pass the modification of the ratio lead us very frequently to modify our prophylactic therapeutics