PMID- 16689753
OWN - NLM
STAT- MEDLINE
DCOM- 20060731
LR  - 20230829
IS  - 1538-7933 (Print)
IS  - 1538-7836 (Linking)
VI  - 4
IP  - 5
DP  - 2006 May
TI  - Markers of hypercoagulability and inflammation predict mortality in patients with 
      heart failure.
PG  - 1017-22
AB  - BACKGROUND AND AIMS: Plasma levels of inflammatory markers are increased in 
      chronic heart failure (HF) and are also subclinical indicators of future HF. 
      Inflammation is strictly correlated with clotting activation, but the association 
      between inflammation, hypercoagulability and prognosis in HF has not been 
      previously reported. METHODS AND RESULTS: Markers of inflammation (interleukin-6; 
      IL-6, and C-reactive protein; CRP) and hypercoagulability (D-dimer; DD, and 
      thrombin-antithrombin III complex; TAT) were prospectively assessed in 214 
      subjects with New York Heart Association (NYHA) functional class II-IV HF. During 
      a median follow-up of 8.5 months, 32 patients had an event: 13 died and 19 were 
      hospitalized because of worsening of HF. IL-6, DD and TAT levels were all 
      significantly associated with increased risk of death after adjustment for other 
      known HF prognostic factors (age, gender, traditional cardiovascular risk 
      factors, NYHA class, systolic left ventricular function, renal failure, 
      hemoglobin, serum sodium) in a Cox multivariate proportional hazard model (P = 
      0.003, P = 0.01 and P = 0.02, respectively). When these markers were added 
      simultaneously to the known prognostic factors in a new Cox multivariate model, 
      only DD levels were significant predictors of mortality (hazard ratio [95% 
      confidence interval; CI]: 11 [2.7-45.1], P = 0.001). The Kaplan-Meier curve 
      revealed a significantly better outcome in patients with DD below 450 ng mL(-1). 
      NT-pro-BNP was the only significant predictor of rehospitalization (HR [95% CI]: 
      5.3 [2.0-13.8], P < 0.001). CONCLUSION: Hypercoagulability and inflammation, as 
      assessed by DD, TAT and IL-6 levels, are associated with an increased mortality 
      risk in HF.
FAU - Marcucci, R
AU  - Marcucci R
AD  - Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, 
      University of Florence, Viale Morgagni 85, 50134 Florence, Italy. 
      r.marcucci@dac.unifi.it
FAU - Gori, A M
AU  - Gori AM
FAU - Giannotti, F
AU  - Giannotti F
FAU - Baldi, M
AU  - Baldi M
FAU - Verdiani, V
AU  - Verdiani V
FAU - Del Pace, S
AU  - Del Pace S
FAU - Nozzoli, C
AU  - Nozzoli C
FAU - Abbate, R
AU  - Abbate R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Biomarkers)
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 0 (Interleukin-6)
RN  - 0 (antithrombin III-protease complex)
RN  - 0 (fibrin fragment D)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 9000-94-6 (Antithrombin III)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - EC 3.4.- (Peptide Hydrolases)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antithrombin III
MH  - Biomarkers/*blood
MH  - *Blood Coagulation Disorders
MH  - C-Reactive Protein/*metabolism
MH  - Cardiac Output, Low/*blood/drug therapy/mortality
MH  - Female
MH  - Fibrin Fibrinogen Degradation Products/*metabolism
MH  - Heart Function Tests
MH  - Humans
MH  - Inflammation
MH  - Interleukin-6/*blood
MH  - Male
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Hydrolases/*blood
MH  - Risk Factors
EDAT- 2006/05/13 09:00
MHDA- 2006/08/01 09:00
CRDT- 2006/05/13 09:00
PHST- 2006/05/13 09:00 [pubmed]
PHST- 2006/08/01 09:00 [medline]
PHST- 2006/05/13 09:00 [entrez]
AID - S1538-7836(22)12249-X [pii]
AID - 10.1111/j.1538-7836.2006.01916.x [doi]
PST - ppublish
SO  - J Thromb Haemost. 2006 May;4(5):1017-22. doi: 10.1111/j.1538-7836.2006.01916.x.