The risk of elevated plasma fibrinogen level in hypertensive and normotensive patientsafter bevacizumabintravitreal injection in diabetic retinopathy

https://doi.org/10.19106/JMedSci005201202007

Ni Luh Putu Widhyasti(1*), Anik Ika Winarni(2), Natalia Christina Angsana(3), Rizto Wisuda Senuari(4), Angela Nurini Agni(5), Agus Supartoto(6), Suhardjo Prawiroranu(7), Tri Wahyu Widayanti(8), Tatang Talka Gani(9), Usi Sukorini(10)

(1) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(2) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(3) Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(4) Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(5) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(6) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(7) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(8) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(9) Department of ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
(10) Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada-dr. Sardjito General Hospital
(*) Corresponding Author

Abstract


Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 non-hypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups.


Keywords


Fibrinogen; hypertension; bevacizumab; IVB; diabetic retinopathy;

Full Text:

PDF


References

  1. Jager RD, Aiello LP, Patel SC, Cunningham ET. Risks of intravitreous injection: a comprehensive review. Retina 2004; 24(5):676-98. https://doi.org/10.1097/00006982-200410000-00002
  2. Yi Z, Chen C, Su Y, Li L, Zhou Y. Changes in clotting time, plasma fibrinogen levels, and blood viscosity after administration of ranibizumab for treatment of choroidal neovascularization. Curr Eye Res 2014; 40(11):1166-71. https://doi.org/10.3109/02713683.2014.990638
  3. Al-droos M, Qubain W. The effect of intravitreal avastin on systemic blood pressure in controlled hypertensive patients. Med J Islam World Acad Sci 2013;21(2):77-80.
  4. Alahmari AK, Almalki ZS, Alahmari AK, Guo JJ. Thromboembolic events associated with bevacizumab plus chemotherapy for patients with colorectal cancer: a meta-analysis of randomized controlled trials. Am Health Drug Benefits 2016; 9(4):221-32.
  5. Pożarowska D, Pożarowski P. The era of anti-vascular endothelial growth factor (VEGF) drugs in ophthalmology, VEGF and anti-VEGF therapy. Cent Eur J Immunol 2016; 41(3):311-6. https://doi.org/10.5114/ceji.2016.63132
  6. Costagliola C, Agnifili L, Arcidiacono B, Duse S, Fasanella V, Mastropasqua R, et al. Systemic thromboembolic adverse events in patients treated with intravitreal anti-VEGF drugs for neovascular age-related macular degeneration. Expert Opin Biol Ther 2012; 12(10):1299-313. https://doi.org/10.1517/14712598.2012.707176
  7. Eldour AAA, Khalafallah TO, Noja HM, Saad ESM, Elsayid M, Babker AMAAA. Fibrinogen Levels in Hypertensive and Normotensive : A Cross-Sectional Study from. J Biosci Med 2016; 4(2):28-32.
  8. Majeed A, Rashid A, Maqbool R, Rashid W, Ahmed M, Gulzar U. Serum fibrinogen levels and its relation to hypertension. Int J Sci Stud 2016; 3(12):72-5. https://doi.org/10.17354/ijss/2016/124
  9. Pourmoghddas A, Gharipour M, Garakyaraghi M, Nouri F, Sadeghi M. Association of socioeconomic status and hypertension based on habitual smoking among Iranian population : IHHP study. Acta Biomed 2018; 89(4):498-504. https://doi.org/10.23750/abm.v89i4.5169
  10. Stec JJ, Silbershatz H, Tofler GH, Matheney TH, Sutherland P, Lipinska I, et al. Association of fibrinogen with cardiovascular risk factors and cardiovascular disease in the framingham offspring population. Circulation 2000; 102(14):1634-8. https://doi.org/10.1161/01.cir.102.14.1634
  11. Sechi LA, Zingaro L, Catena C, Casaccio D, De Marchi S. Relationship of fibrinogen levels and hemostatic abnormalities with organ damage in hypertension. Hypertension 2000; 36(6):978-85. https://doi.org/10.1161/01.hyp.36.6.978
  12. van derBom JG, de Maat MP, Bots ML, Haverkate F, de Jong PT, Hofman A, et al. Elevated plasma fibrinogen cause or consequence of cardiovascular disease? Arter Thromb Vasc Biol 1998; 18(4):621-5. https://doi.org/10.1161/01.atv.18.4.621
  13. García-Quintanilla L, Luaces-Rodríguez A, Gil-Martínez M, Mondelo-García C, Maroñas O, Mangas-Sanjuan V, et al. Pharmacokinetics of intravitreal anti-VEGF drugs in age-related macular degeneration. Pharmaceutics 2019; 11(8):e365. https://doi.org/10.3390/pharmaceutics11080365
  14. Bakri SJ, Snyder MR, Reid JM, Pulido JS, Sing RJ. Pharmacokinetics of intravitreal bevacizumab (Avastin). Ophthalmology 2007; 114(5):855-9. https://doi.org/10.1016/j.ophtha.2007.01.017
  15. Avery RL. What is the evidence for systemic effects of intravitreal anti-VEGF agents , and should we be concerned? Br J Ophthalmol 2014; 98(Suppl 1):7-10. https://doi.org/10.1136/bjophthalmol-2013-303844
  16. Fiebai B, Odogu V. Intravitreal anti vascular endothelial growth factor agents in the management of retinal diseases : an audit. Open Ophthalmol J 2017; 11:315-21. https://doi.org/10.2174/1874364101711010315
  17. Semeraro F, Morescalchi F, Duse S, Gambicorti E, Cancarini A, Costagliola C. Pharmacokinetic and pharmacodynamic properties of anti-VEGF Drugs after intravitreal injection. Curr Drug Metab 2015; 16(7):572-84. https://doi.org/10.2174/1389200216666151001120831
  18. Amadio M, Govoni S, Pascale A. Targeting VEGF in eye neovascularization: What’s new? a comprehensive review on current therapies and oligonucleotide-based interventions under development. Pharmacol Res 2016; 103:253-69. https://doi.org/10.1016/j.phrs.2015.11.027
  19. Bembde AS. A study of plasma fibrinogen level in type-2 diabetes mellitus and its relation to glycemic control. Indian J Hematol Blood Transfus 2012; 28(2):105-8. https://doi.org/10.1007/s12288-011-0116-9
  20. Mahendra JV, Kumar SD, Anuradha TS, Talikoti P, Nagaraj RS, Vishali V. Plasma fibrinogen in type 2 diabetic patients with metabolic syndrome and its relation with ischemic heart disease ( IHD ) and retinopathy. J Clin Diagn Res 2015; 9(1):18-21. https://doi.org/10.7860/JCDR/2015/10712.5449



DOI: https://doi.org/10.19106/JMedSci005201202007

Article Metrics

Abstract views : 1565 | views : 1655


Bookmark and Share


Copyright (c) 2020 Ni Luh Putu Widhyasti, Anik Ika Winarni, Natalia Christina Angsana, Rizto Wisuda Senuari, Angela Nurini Agni, Agus Supartoto, Suhardjo Prawiroranu, Tri Wahyu Widayanti, Tatang Talka Gani, Usi Sukorini

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

FUJI188