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Short term effects of GnRH agonists on plasma fibrinolytic balance in patients with advanced prostate cancer

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Abstract

Background Gonadotropin releasing hormone (GnRH) agonists are the cornerstone of metastatic prostate cancer treatment. Cardiovascular effects of GnRH agonists are unclear. In this study, we investigated the short term effects of GnRH agonists on plasma fibrinolytic parameters in patients with metastatic prostate cancer. Methods Eleven patients (mean age 69.3 ± 6.5) with metastatic prostate cancer and a clinical indication for GnRH agonist therapy were selected. Plasma plasminogen activator inhibitor (PAI-1) antigen (Ag), tissue plasminogen activator (t-PA) Ag and thrombin-activatable fibrinolysis inhibitor (TAFI) activity levels were measured at baseline and at 4 weeks after the first dose of GnRH agonist, Goserelin Acetate (Zoladex®, subcutaneous administration, 10.8 mg). Results Serum prostate specific antigen (PSA) levels significantly decreased from 36.6 ± 19.3 to 1.1 ± 0.3 ng/ml after Goserelin acetate treatment (P = 0.005). Significant changes occurred in the fibrinolytic parameters. GnRH agonists decreased plasma t-PA Ag levels (16.3 ± 4.9 vs. 12.2 ± 2.8 ng/ml, P = 0.047) and increased PAI-1/t-PA molar ratio (4.8 ± 3.6 vs. 6.6 ± 3.4, P = 0.16), on the other hand, plasma PAI-1 Ag (59.0 ± 48.5 vs. 56.4 ± 30.5 ng/ml, P = 0.8), and TAFI levels (130.6 ± 9.5 vs. 124.2 ± 26.5% activity, P = 0.3) did not change significantly. Conclusion This study provides evidence that GnRH agonists may inhibit fibrinolytic system by decreasing t-PA levels.

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References

  1. D’Amico AV, Denham JW, Crook J, Chen MH, Goldhaber SZ, Lamb DS, Joseph D, Tai KH, Malone S, Ludgate C, Steigler A, Kantoff PW (2007) Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions. J Clin Oncol 25:2420–2425

    Article  PubMed  CAS  Google Scholar 

  2. Agirbasli M (2005) Pivotal role of plasminogen-activator inhibitor 1 in vascular disease. Int J Clin Pract 59:102–106

    Article  PubMed  CAS  Google Scholar 

  3. Chandler WL (1991) A kinetic model of the circulatory regulation of tissue plasminogen activator. Thromb Haemost 66:321–328

    PubMed  CAS  Google Scholar 

  4. Smith MR (2007) Androgen deprivation therapy for prostate cancer: new concepts and concerns. Curr Opin Endocrinol Diabetes Obes 14:247–254

    PubMed  Google Scholar 

  5. Sartorato P, Zulian E, Benedini S, Mariniello B, Schiavi F, Bilora F, Pozzan G, Greggio N, Pagnan A, Mantero F, Scaroni C (2007) Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab 92:1015–1018

    Article  PubMed  CAS  Google Scholar 

  6. Smith MR, Lee H, Nathan DM (2006) Insulin sensitivity during combined androgen blockade for prostate cancer. J Clin Endocrinol Metab 91:1305–1308

    Article  PubMed  CAS  Google Scholar 

  7. Jin H, Lin J, Fu L, Mei YF, Peng G, Tan X, Wang DM, Wang W, Li YG (2007) Physiological testosterone stimulates tissue plasminogen activator and tissue factor pathway inhibitor and inhibits plasminogen activator inhibitor type 1 release in endothelial cells. Biochem Cell Biol 85:246–251

    Article  PubMed  CAS  Google Scholar 

  8. Glueck CJ, Glueck HI, Stroop D, Speirs J, Hamer T, Tracy T (1993) Endogenous testosterone, fibrinolysis, and coronary heart disease risk in hyperlipidemic men. J Lab Clin Med 122:412–420

    PubMed  CAS  Google Scholar 

  9. Rubio-Gayosso I, Garcia-Ramirez O, Gutierrez-Serdan R, Guevara-Balcazar G, Muñoz-García O, Morato-Cartajena T, Zamora-Garza M, Ceballos-Reyes G (2002) Testosterone inhibits bradykinin-induced intracellular calcium kinetics in rat aortic endothelial cells in culture. Steroids 67:393–397

    Article  PubMed  CAS  Google Scholar 

  10. Brown NJ, Agirbasli MA, Williams GH, Litchfield WR, Vaughan DE (1998) Effect of activation and inhibition of the renin–angiotensin system on plasma PAI-1. Hypertension 32:965–971

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Marmara University School of Medicine, Tophanelioglu Caddesi 13/15, Altunizade, Istanbul, 34662, Turkey

    Mehmet Agirbasli, Oytun A. Baykan & Altug A. Cincin

  2. Department of Urology, Haydarpasa Numune Hospital, Haydarpasa, Istanbul, Turkey

    Ali Tekin & Feridun Sengor

  3. Department of Internal Medicine, Division of Hematology, Trakya University School of Medicine, Edirne, Turkey

    Muzaffer Demir

  4. Department of Internal Medicine, Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Douglas E. Vaughan

Authors
  1. Mehmet Agirbasli
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  2. Oytun A. Baykan
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  3. Ali Tekin
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  4. Feridun Sengor
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  5. Altug A. Cincin
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  6. Muzaffer Demir
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  7. Douglas E. Vaughan
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Correspondence to Mehmet Agirbasli.

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Agirbasli, M., Baykan, O.A., Tekin, A. et al. Short term effects of GnRH agonists on plasma fibrinolytic balance in patients with advanced prostate cancer. J Thromb Thrombolysis 27, 172–174 (2009). https://doi.org/10.1007/s11239-007-0188-4

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  • DOI: https://doi.org/10.1007/s11239-007-0188-4

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