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Activation of haemostasis in elderly patients with chronic heart failure

Abstract number: PP-TH-361

Shmeleva¹ V.M., Semenova² O.N.

¹¹laboratory of blood coagulation, Institute of Haematology and Transfusion, Sant-Petersburg ²²StPetersburg Center for Treatment of Leningrad blockade survivors, State Clinic, Sant Petersburg, Russian Federation

How-to-cite Shmeleva VM, Semenova ON. Activation of haemostasis in elderly patients with chronic heart failure. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract PP-TH-361

The question for the clinician is to identify patients at high thrombosis risk and prevent thrombosis not increasing risk of bleeding. The aim of our study was to evaluate the state of blood coagulation in elderly patients with high class (III – IV) chronic heart failure (CHF). The study involved 110 unrelated patients (25 men and 85 women, age range 65–87, mean age 73 years) and 50 age and sex matched controls. APTT, PT, TT, VWF R:Co%, fibrinogen, homocysteine (Hcy) and D-dimers (D-d) levels were detected. For D-d Roche Diagnostics test was used. Hcy levels were determined by HPLC with hyperhomocysteinemia (HHcy) defined as Hcy levels > 15 micromol/l. Mean plasma Hcy levels were significantly higher in patients than in controls (15 micromol/l vs. 9 micromol/l). HHcy was present in 42% patients with CHF vs. 3,2% in control group. Abnormal fibrinogen levels were found in 7% of cases. APTT, PT and TT were within normal range in all cases. Mean VWF R:Co % was significantly higher in patients than in controls (183% vs. 99,5%); VWF R:Co % >180% was detected in 40% of cases. 95,2% of patients had D-d levels >500 ng/ml; among those 22,6% - 1000 ng/ml, 15,4% - 2000 ng/ml, 24% > 3000 ng/ml. Abnormal D-d were not associated with lipid disturbances and hyperglycemia. The prevalence of high D-d levels was significantly higher among patients with HHcy. D-d levels >3000 ng/ml were detected in 28% cases with HHcy vs. 15% with normal Hcy (P < 0,001) and in 35% patients with ejection fraction < 50% vs. 15% patients with ejection fraction >50%. We suggest HHcy to be possible trigger of D-d elevation in elderly. We conclude HHcy, D-d levels and VWF R:Co % were sensitive markers of hypercoagulation in contrast to fibrinogen levels, APTT, PT, TT. Further investigation would show whether combination of these markers is a signal to start anticoagulant therapy in elderly CHF patients.

Disclosure of interest: none declared.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

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