Alveolar inflammation induced by particles may either directly or via oxidative stress lead to systemic inflammation with increased levels of blood coagulability
, progression of atherosclerosis, and destabilization or even rupture of vulnerable plaques, resulting in acute ischemic events (Brook et al.
Francis et al (6) tested the coagulability
of patients with colon cancer using TEG and found them to be significantly hypercoagulable.
The observations that CPAP therapy can alleviate some of these abnormalities and can reduce factor VII clotting activity (102) and morning increases in the plasma fibrinogen concentration and whole blood viscosity, (102) suggest that OSA may be causally related to increased coagulability
In 1856, Virchow developed a triad that postulated the elements affecting the development of venous thromboemboli as: (1) trauma to the vessel endothelial wall, (2) stasis or a decrease in the rate of blood flow in the veins and (3) changes in the coagulability
of the blood, specifically hypercoagulability.
Immobility or the paralysis of a limb exposes a patient to venous stasis and increased blood coagulability
, which could lead to the development of deep vein thrombosis (DVT) and the risk of thromboembolism.
Systemic alterations in rheologic factors, including blood coagulability
and whole blood viscosity as a result of exposure to PM, represent other potential mechanisms of PM toxicity (Pekkanen et al.
Philosophically, they are unconcerned whether they are scaling hypercoagulability down to normal coagulability
or normal coagulability
down to hypocoagulability.
This elevated risk can occur via increased coagulability
of the blood (Seaton et al.
Virchow's perception of coagulability
(and hypercoagulability) was far less refined, but he did allude to the concentration of fibrin in the blood as a potential determinant of coagulability
, and he recognized that the blood's "adhesiveness" could be increased by adding oil, paste, and other substances to the blood.
In addition to direct alveolar translocation of NSPs, cardiovascular effects may also be the corollary of a sequence of events starting with particle-induced alveolar inflammation initiating a systemic acute phase response with changes in blood coagulability
and resulting in cardiovascular effects (Seaton et al.
It is conceivable that the combined effect of transient increases in blood coagulability
(Seaton et al.