Assessment of Coagulation and Hemostasis Biomarkers in a Subset of Patients With Chronic Cardiovascular Disease

Abstract

Measurement of a single marker of coagulation may not provide a complete picture of hemostasis activation and fibrinolysis in patients with chronic cardiovascular diseases. We assessed retrospective orders of a panel which included prothrombin fragment 1.2 (PF1.2), thrombin: antithrombin complexes, fibrin monomers, and D-dimers in patients with heart assist devices, cardiomyopathies, atrial fibrillation and intracardiac thrombosis (based on ordering ICD-10 codes). During 1 year there were 117 panels from 81 patients. Fifty-six (69%) patients had heart assist devices, cardiomyopathy was present in 17 patients (21%) and 29 patients (36%) had more than 1 condition. PF1.2 was most frequently elevated in patients with cardiomyopathy (61.1%) compared to those with cardiac assist devices (15.7%; P = 0.0002). D-dimer elevation was more frequent in patients with cardiac assist devices (98.8%) compared to those patients with cardiomyopathy (83.3%; P = 0.014). Patients with cardiomyopathy show increases of PF1.2 suggesting thrombin generation. In contrast, elevations of D-dimers without increase in other coagulation markers in patients with cardiac assist devices likely reflect the presence of the intravascular device and not necessarily evidence of hemostatic activation.

Cardiologia Esportiva: Desafios E Avanços Na Avaliação Cardíaca De Atletas De Alto Rendimento

“…Podem registrar níveis mais elevados em pacientes com causas diversas de estenose coronária, como a aterosclerose, mas também numa série de outras causas 80 . Em vez de serem biomarcadores cardíacos tradicionais, são úteis no tromboembolismo venoso, trombose do átrio esquerdo em pacientes com fibrilação atrial, acidente vascular cerebral cardioembólico, dissecção aórtica aguda ou mesmo em pessoas com dispositivos cardíacos implantáveis 81,82 .…”

Cardiac Biomarkers in Sports Cardiology

“…They are characterized by a high sensitivity but low specificity, as they may register higher levels in patients with diverse causes of coronary stenosis, such as atherosclerosis, but also in a number of other causes [90]. Rather than being traditional cardiac biomarkers, they are useful in venous thromboembolism, left atrium thrombosis in patients with atrial fibrillation, cardioembolic stroke, acute aortic dissection, or even in persons with implantable cardiac devices (see Table 2) [91,92]. [91,92]).…”

“…Rather than being traditional cardiac biomarkers, they are useful in venous thromboembolism, left atrium thrombosis in patients with atrial fibrillation, cardioembolic stroke, acute aortic dissection, or even in persons with implantable cardiac devices (see Table 2) [91,92]. [91,92]).…”

“…Coronary atherosclerosis [91,92] Venous thrombosis Pulmonary embolism Atrial fibrillation with atrial thrombus Cardioembolic stroke Acute aortic dissection Implantable cardiac devices In athletes, D-Dimers are used more to evaluate the thromboembolic risk and the effect certain physical activities or diets have on the hemostatic system. For example, as far back as 1995, it has been shown that steroid usage in weightlifters results in higher D-Dimer values compared to athletes who did not use any form of supplement.…”

Cardiopulmonary Exercise Testing and Cardiac Biomarker Measurements in Young Football Players: A Pilot Study

“…They have more use in confirming or infirming venous thromboembolism, acute aortic dissection, cardioembolic stroke, or left atrium thrombosis in patients with atrial fibrillation [ 49 ]. Additionally, an independent rise in their levels can be specific in persons with implantable cardiac devices [ 50 ].…”