Abstract Number: PB1336
Meeting: ISTH 2022 Congress
Background: Blood coagulation is a complex and highly coordinated process, modulated by procoagulant and anticoagulant factors. Genetic or environmental defects in their hemostatic balance contribute to venous thromboembolism (VTE). We hypothesized that patterns in coagulation system activity observed in acute VTE may also predict recurrent events.
Aims: To identify patterns of coagulation factors and their relation with risk factors and clinical outcomes of VTE patients.
Methods: Acute-phase plasma samples from 612 subjects from the GMP-VTE project were analyzed. This study was approved by the local Ethics Committee. All patients signed the informed consent. FII, FVII, FVIII, FIX, FX, FXI, FXIII, activated Protein C (aPC), Protein S (PS), D-dimer, fibrinogen, tissue factor protein inhibitor (TFPI), thrombomodulin and plasminogen activator inhibitor-1 levels were quantified, and principal component (PC) analysis was used to derive coagulation system patterns. Cox regression and elastic net-regularized linear regression were used to identify associations of PC scores with clinical outcome and risk factors.
Results: Four PCs were retained, accounting for 51.3% of the total variance. PC1 was mainly driven by vitamin K dependent factors (FII, FVII, FX, and aPC); PC2 by FVIII, FIX, FXI, and fibrinogen; PC3 by D-dimer and FXIII, and TFPI and PS contributed to PC4. PC3 and PC4 significantly predicted recurrent VTE risk (HR: 1.27; 95 %CI: [1.05-1.53]; p=0.014, and 1.31 [1.06-1.62]; p=0.013, respectively), independently of age, sex, body mass, VTE risk factors, thrombus site, and medication intake. Additionally, PC2 and PC4 exhibited good prognostic ability for all-cause death (HR: 1.36 [1.04-1.77]; p=0.024, and 1.76 [1.42-2.20]; p < 0.001). PC4 scores were elevated in subjects with comorbidities reflecting endothelial dysfunction (diabetes, chronic kidney disease, coronary artery disease).
Conclusion(s): Principal component analysis of the coagulation system characterized clusters of thrombo-inflammation and endothelial activation markers related to recurrent VTE and mortality.
APR is supported by EU-TICARDIO No. 813409.
To cite this abstract in AMA style:Pallares Robles A, ten Cate V, Schulz A, Prochaska J, Koeck T, Heitmeier S, Ewert R, Halank M, Espinola-Klein C, Lackner K, Münzel T, ten Cate H, ten Cate-Hoek A, Konstantinides S, Wild P. Clustering of coagulation factors in acute venous thromboembolism identifies clusters of thromboinflammatory and endothelial activation markers as independent predictors of recurrence and mortality. [abstract]. https://abstracts.isth.org/abstract/clustering-of-coagulation-factors-in-acute-venous-thromboembolism-identifies-clusters-of-thromboinflammatory-and-endothelial-activation-markers-as-independent-predictors-of-recurrence-and-mortality/. Accessed September 27, 2023.
« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/clustering-of-coagulation-factors-in-acute-venous-thromboembolism-identifies-clusters-of-thromboinflammatory-and-endothelial-activation-markers-as-independent-predictors-of-recurrence-and-mortality/