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

• Type of Material: Article
• Authors: Maureen J Miller, Emory University; Cheryl Maier, Emory University; Alexander Duncan, Emory University; Jeannette Guarner, Emory University
• Language: English
• Date: 2021-07-07
• Publisher: SAGE PUBLICATIONS INC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/10760296211032292
• Title of Journal or Parent Work: CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
• Volume: 27
• Start Page: 10760296211032292
• End Page: 10760296211032292
• Grant/Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
• Keywords: fibrin monomers; RISK; 2; D-DIMER; MARKERS; d-dimer; Life Sciences & Biomedicine; Hematology; heart disease; ACTIVATION; CANCER; prothrombin factor 1; coagulation; Cardiovascular System & Cardiology; Science & Technology; DIAGNOSIS; Peripheral Vascular Disease; HYPERCOAGULABLE STATE
• Research Categories: Health Sciences, Pathology

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.