Effects of Aging on the Coagulation Fibrinolytic System in Outpatients of the Cardiovascular Department

Background:Although clinical trials demonstrate that the elderly with atrial fibrillation have risks of thrombosis and bleeding, the relationship between aging and coagulation fibrinolytic system in “real-world” cardiology outpatients is uncertain.Methods and Results:We retrospectively evaluated 773...

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Published in:Circulation Journal 2016/09/23, Vol.80(10), pp.2133-2140
Main Authors: Ochi, Akinori, Adachi, Taro, Inokuchi, Koichiro, Ogawa, Ko, Nakamura, Yuya, Chiba, Yuta, Kawasaki, Shiro, Onishi, Yoshimi, Onuma, Yoshimasa, Munetsugu, Yumi, Ito, Hiroyuki, Onuki, Tatsuya, Minoura, Yoshino, Watanabe, Norikazu, Kawamura, Mitsuharu, Asano, Taku, Kobayashi, Youichi
Format: Article
Language:English
Subjects:
Adult
Aged
Aging
Aging - blood
Endothelial dysfunction
Female
Fibrinolysis
Humans
Male
Middle Aged
Outpatients
Retrospective Studies
Thrombophilia - blood
Thrombosis
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Summary:Background:Although clinical trials demonstrate that the elderly with atrial fibrillation have risks of thrombosis and bleeding, the relationship between aging and coagulation fibrinolytic system in “real-world” cardiology outpatients is uncertain.Methods and Results:We retrospectively evaluated 773 patients (mean age: 58 years; 52% men; Asian ethnicity). To thoroughly investigate markers of coagulation and fibrinolysis, we simultaneously measured levels of D-dimer, prothrombin-fragment1+2 (F1+2), plasmin-α2 plasmin inhibitor complex (PIC), and thrombomodulin (TM). There were correlations between aging and levels of F1+2, D-dimer, PIC, and TM (R=0.61, 0.57, 0.49, and 0.30, respectively). We compared 3 age groups, which were defined as the Y group (75 years). Levels of markers were higher in older individuals (D-dimer: 1.0±0.8 vs. 0.8±0.8 vs. 0.6±0.4 μg/ml, F1+2: 281.8±151.3 vs. 224.6±107.1 vs. 155.5±90.0 pmol/L, PIC: 0.9±0.3 vs. 0.8±0.3 vs. 0.6±0.5 μg/ml, and TM: 2.9±0.8 vs. 2.7±0.7 vs. 2.5±0.7FU/ml). We performed logistic regression analysis to determine F1+2 and PIC levels. Multivariate analysis revealed that aging was the most important determinant of high F1+2 and PIC levels.Conclusions:Hypercoagulable states develop with advancing age in “real-world” cardiology outpatients. (Circ J 2016; 80: 2133–2140)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-16-0530