Hypercoagulability in centenarians: the paradox of successful aging

Abstract

With advancing age, an increasing number of healthy individuals have laboratory signs of heightened coagulation enzyme activity. Such biochemical hypercoagulability might be the basis of either the increased thrombotic tendency occurring with age or a harmless manifestation of this process. To see whether these alterations are also present in the very elderly who had aged successfully, 25 healthy centenarians were studied and results of coagulation and fibrinolysis measurements were compared with those obtained in two control groups of healthy adults, 25 ranging in age from 18 to 50 years and 25 from 51 to 69 years. Older controls had, in general, slightly higher values of several coagulation and fibrinolysis measurements than younger controls. Centenarians had striking signs of heightened coagulation enzyme activity, as assessed directly by measuring activated factor VII in plasma (P < .01, compared with either control group) or indirectly by measuring the plasma levels of the activation peptides of prothrombin, factor IX, factor X, and thrombin-antithrombin complexes (all P < .001). Heightened coagulation enzyme activity was accompanied by signs of enhanced formation of fibrin (high fibrinopeptide A, P < .001) and secondary hyperfibrinolysis (high D-dimer and plasmin-antiplasmin complex, P < .001). Plasma concentrations of fibrinogen and factor VIII were higher than in controls, whereas other coagulation factors were not elevated. In conclusion, this study shows the very elderly do not escape the state of hypercoagulability associated with aging, but that this phenomenon is compatible with health and longevity. Hence, high plasma levels of the coagulation activation markers in older populations do not necessarily mirror a high risk of arterial or venous thrombosis.

Lipoprotein(a) and lipoprotein profile in healthy centenarians: a reappraisal of vascular risk factors

“…This finding is in accord with recent data suggesting that high levels of IL-6 are predictors of morbidity in longitudinal studies of cohorts of elderly people (26). From this point of view, the occurrence of healthy centenarians with high levels of IL-6 is another paradox to be added to the increasing list of risk factors that apparently change their biological significance in centenarians (12,25). This finding regarding the serum level of Lp(a) in centenarians occurs concomitantly with other interesting changes in serum levels of other major lipids and lipoproteins.…”

“…Moreover, an increase in the production of proinflammatory cytokines, particularly IL-6, occurs with age (18,24), and includes centenarians (unpublished data). Accordingly, Lp(a) could behave as an acute-phase protein, such as fibrinogen, which also showed a paradoxical increase in healthy centenarians (25).…”

Extended Monitoring of Hemostatic Activation After Varicose Vein Surgery Under General Anesthesia

“…Initially elevated TAT and PAP values within this subgroup could be explained by advanced age. 21 Similar to the bimodal curve of all TPP values, TAT values of the subgroup showed an immediate postoperative peak and Figure 6. Tissue plasminogen activator (t-PA) antigen showed no significant increase.…”

Risk Factors for Deep Vein Thrombosis in Inpatients Aged 65 and Older: A Case‐Control Multicenter Study

“…[14][15][16][17][18] Three studies have investigated the importance of multiple medical risk factors for a first symptomatic DVT using logistic regression but only in younger outpatients. 9,[19][20][21] Because this disease is more frequently encountered in elderly hospitalized patients than in others, and physiological changes of hemostasis due to age are likely to modify the risk of DVT in older adults, 22,23 it seems to be relevant to study the independent risk factors of DVT in this population.…”