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Thrombotic biomarkers and left ventricle characteristics as short-term predictors of thrombotic events in patients hospitalized for acute decompensated heart failure.
Eur J Intern Med. 2012 Sep; 23(6):545-51.EJ

Abstract

BACKGROUND

Hospitalized acute decompensated heart failure (ADHF) patients have high risk of thromboembolic events (TE). The aim of this study is to determine the short-term prognostic value of TE for different thrombotic biomarkers (fibrinogen; D-dimer; tissue plasminogen activator antigen, t-PA; and plasminogen-activator inhibitor type 1 antigen, PAI-1) and left ventricle echocardiographic characteristics (diastolic diameter, LVDD; ejection fraction, LVEF) in admitted ADHF patients.

METHODS AND RESULTS

We included 140 patients with ADHF in NYHA classes III-IV (October 2009 to November 2011). Subjects with anticoagulant drugs, arrhythmias, or thrombosis were excluded. Biochemical and echocardiographic data were obtained within 12h after admission and all patients were given enoxaparin 40 mg/day. Throughout hospitalization (median, 11 days), 14 subjects (10.0%) with ADHF received a TE diagnosis. Pulmonary embolism (PE, 5.0%), deep-vein thrombosis (DVT, 7.1%), or a combination of these were confirmed in 3, 6 and 4 patients respectively. Cardioembolic stroke was diagnosed in 1 subject (0.7%) associated with left ventricular intracavitary thrombus developed after admission. The following determinations most strongly predicted the short-term risk of TE: fibrinogen>500 mg/dL (Odds Ratio [OR] 6.19; p=.0019), D-dimer>600 ng/dL (OR 7.84; p=.0009), t-PA>10 ng/dL (OR 7.22; p=.0007), PAI-1>30 ng/dL (OR 8.70; p<.0006), LVDD>50mm (OR 5.67; p=.0039), and LVEF<30% (OR 5.48; p=.0163).

CONCLUSIONS

Elevated levels of fibrinogen, D-dimer, t-PA and PAI-1 antigens as well as a dilated left ventricle with poor systolic function determined at admission are associated with a significantly high short-term risk of TE.

Authors+Show Affiliations

Department of Internal Medicine, San Juan de Dios Hospital, Buenos Aires, Argentina. graispuru@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22863433

Citation

Aispuru, Gualberto Rodrigo, et al. "Thrombotic Biomarkers and Left Ventricle Characteristics as Short-term Predictors of Thrombotic Events in Patients Hospitalized for Acute Decompensated Heart Failure." European Journal of Internal Medicine, vol. 23, no. 6, 2012, pp. 545-51.
Aispuru GR, Clavier MM, Cardone AJ, et al. Thrombotic biomarkers and left ventricle characteristics as short-term predictors of thrombotic events in patients hospitalized for acute decompensated heart failure. Eur J Intern Med. 2012;23(6):545-51.
Aispuru, G. R., Clavier, M. M., Cardone, A. J., Gilberto, D. O., & Barousse, A. P. (2012). Thrombotic biomarkers and left ventricle characteristics as short-term predictors of thrombotic events in patients hospitalized for acute decompensated heart failure. European Journal of Internal Medicine, 23(6), 545-51. https://doi.org/10.1016/j.ejim.2012.04.002
Aispuru GR, et al. Thrombotic Biomarkers and Left Ventricle Characteristics as Short-term Predictors of Thrombotic Events in Patients Hospitalized for Acute Decompensated Heart Failure. Eur J Intern Med. 2012;23(6):545-51. PubMed PMID: 22863433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thrombotic biomarkers and left ventricle characteristics as short-term predictors of thrombotic events in patients hospitalized for acute decompensated heart failure. AU - Aispuru,Gualberto Rodrigo, AU - Clavier,Marcel María, AU - Cardone,Alberto José, AU - Gilberto,Daniel Oscar, AU - Barousse,Amadeo Pedro, Y1 - 2012/04/30/ PY - 2012/01/09/received PY - 2012/03/26/revised PY - 2012/04/04/accepted PY - 2012/8/7/entrez PY - 2012/8/7/pubmed PY - 2013/1/5/medline SP - 545 EP - 51 JF - European journal of internal medicine JO - Eur J Intern Med VL - 23 IS - 6 N2 - BACKGROUND: Hospitalized acute decompensated heart failure (ADHF) patients have high risk of thromboembolic events (TE). The aim of this study is to determine the short-term prognostic value of TE for different thrombotic biomarkers (fibrinogen; D-dimer; tissue plasminogen activator antigen, t-PA; and plasminogen-activator inhibitor type 1 antigen, PAI-1) and left ventricle echocardiographic characteristics (diastolic diameter, LVDD; ejection fraction, LVEF) in admitted ADHF patients. METHODS AND RESULTS: We included 140 patients with ADHF in NYHA classes III-IV (October 2009 to November 2011). Subjects with anticoagulant drugs, arrhythmias, or thrombosis were excluded. Biochemical and echocardiographic data were obtained within 12h after admission and all patients were given enoxaparin 40 mg/day. Throughout hospitalization (median, 11 days), 14 subjects (10.0%) with ADHF received a TE diagnosis. Pulmonary embolism (PE, 5.0%), deep-vein thrombosis (DVT, 7.1%), or a combination of these were confirmed in 3, 6 and 4 patients respectively. Cardioembolic stroke was diagnosed in 1 subject (0.7%) associated with left ventricular intracavitary thrombus developed after admission. The following determinations most strongly predicted the short-term risk of TE: fibrinogen>500 mg/dL (Odds Ratio [OR] 6.19; p=.0019), D-dimer>600 ng/dL (OR 7.84; p=.0009), t-PA>10 ng/dL (OR 7.22; p=.0007), PAI-1>30 ng/dL (OR 8.70; p<.0006), LVDD>50mm (OR 5.67; p=.0039), and LVEF<30% (OR 5.48; p=.0163). CONCLUSIONS: Elevated levels of fibrinogen, D-dimer, t-PA and PAI-1 antigens as well as a dilated left ventricle with poor systolic function determined at admission are associated with a significantly high short-term risk of TE. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/22863433/Thrombotic_biomarkers_and_left_ventricle_characteristics_as_short_term_predictors_of_thrombotic_events_in_patients_hospitalized_for_acute_decompensated_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(12)00089-1 DB - PRIME DP - Unbound Medicine ER -