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In the present study we investigated whether described prothrombotic blood alterations might predispose to thromboembolic events or asthma exacerbations. In 164 adult asthmatics we assessed clinical events during 3-year follow-up and analyzed their associations with measured at baseline prothrombotic blood parameters. Data were obtained from 157 (95.7%) of the asthma patients. We documented 198 severe asthma exacerbations (64\/year), which occurred in 53 subjects (34%). These patients were older (p\u2009=\u20090.004), had worse asthma control (p\u2009=\u20090.02) and lower spirometry values (p\u2009=\u20090.01), at baseline. Interestingly, this subgroup had longer clot lysis time (CLT), as well as lower \u03b1<jats:sub>2<\/jats:sub>-macroglobulin (p\u2009=\u20090.038 and p\u2009=\u20090.04, respectively, after adjustment for potential confounders). Increased CLT and lower \u03b1<jats:sub>2<\/jats:sub>-macroglobulin were demonstrated as independent predictors of asthma exacerbation in multiple regression model. Moreover, we documented two episodes of deep vein thrombosis (1.3%), and eight acute coronary syndromes (5.1%). Patients who experienced thromboembolic events (n\u2009=\u200910, 6.4%, 2.1%\/year) had lower \u03b1<jats:sub>2<\/jats:sub>-macroglobulin (p\u2009=\u20090.04), without differences in efficiency of fibrinolysis and thrombin generation. Impaired fibrinolysis and lower levels of \u03b1<jats:sub>2<\/jats:sub>-macroglobulin might predispose to a higher rate of asthma exacerbations, suggesting new links between disturbed hemostasis and asthma.<\/jats:p>","DOI":"10.1038\/s41598-017-11467-8","type":"journal-article","created":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T14:05:44Z","timestamp":1504533944000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impaired fibrinolysis and lower levels of plasma \u03b12-macroglobulin are associated with an increased risk of severe asthma exacerbations"],"prefix":"10.1038","volume":"7","author":[{"given":"Stanislawa","family":"Bazan-Socha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucyna","family":"Mastalerz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Cybulska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lech","family":"Zareba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romy","family":"Kremers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Zabczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazyna","family":"Pulka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Iwaniec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan G.","family":"Bazan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coenraad","family":"Hemker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anetta","family":"Undas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,9,8]]},"reference":[{"key":"11467_CR1","unstructured":"Global Initiative for Asthma (GINA) Report. 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