Altered Hypercoagulability Factors in Patients with Chronic Chagas Disease: Potential Biomarkers of Therapeutic Response

Thromboembolic events were described in patients with chagas disease without cardiomyopathy. we aim to confirm if there is a hypercoagulable state in these patients and to determine if there is an early normalization of hemostasis factors after antiparasitic treatment. ninety-nine individuals from chagas disease-endemic areas were classified in two groups: g1,with t.cruzi infection (n = 56); g2,healthy individuals (n = 43). twenty-four hemostasis factors were measured at baseline. g1 patients treated with benznidazole were followed for 36 months,recording clinical parameters and performance of conventional serology,chemiluminescent enzyme-linked immunosorbent assay (trypomastigote-derived glycosylphosphatidylinositol-anchored mucins),quantitative polymerase chain reaction,and hemostasis tests every 6-month visits. prothrombin fragment 1+2 (f1+2) and endogenous thrombin potential (etp) were abnormally expressed in 77% and 50% of infected patients at baseline but returned to and remained at normal levels shortly after treatment in 76% and 96% of cases,respectively. plasmin-antiplasmin complexes (pap) were altered before treatment in 32% of g1 patients but normalized in 94% of cases several months after treatment. none of the patients with normal f1+2 values during follow-up had a positive qrt-pcr result,but 3/24 patients (13%) with normal etp values did. in a percentage of chronic t. cruzi infected patients treated with benznidazole,altered coagulation markers returned into normal levels. f1+2,etp and pap could be useful markers for assessing sustained response to benznidazole. © 2016 pinazo et al.