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Prognostic impact of haemostatic derangements in chronic heart failure

Borut Jug1, Nina Vene, Barbara Guzic Salobir

  • 1Department of Vascular Diseases, University Clinical Center Ljubljana, Zaloska 7/VI, Ljubljana, Slovenia. borut.jug@gmail.com

Thrombosis and Haemostasis
|August 5, 2009
PubMed

Insights

In chronic heart failure patients, elevated tissue plasminogen activator (tPA) antigen levels independently predict poor prognosis. Higher tPA levels indicate a greater risk of heart failure events, including death or hospitalization.

Area of Science:

  • Cardiology
  • Haemostasis Research
  • Biomarker Discovery

Background:

  • Heart failure is associated with an overactive blood clotting system (haemostasis).
  • The prognostic significance of specific haemostatic markers in chronic heart failure remains incompletely understood.

Purpose of the Study:

  • To investigate the prognostic value of key haemostatic markers in stable, outpatients with chronic heart failure.
  • To determine if markers like prothrombin fragment F1+2, D-dimer, and tissue plasminogen activator (tPA) predict future adverse events.

Main Methods:

  • 195 stable outpatients with chronic heart failure were enrolled.
  • Baseline blood levels of prothrombin fragment F1+2, D-dimer, tPA, and PAI-1 antigens were measured.
  • Patients were followed for adverse events (heart failure-related death or hospitalization).

Main Results:

  • Patients experiencing an event had significantly higher levels of tPA antigen and D-dimer.
  • Multivariate analysis identified elevated tPA antigen levels (above 10.2 microg/l) as an independent predictor of prognosis.
  • D-dimer levels did not independently predict prognosis in this cohort.

Conclusions:

  • Elevated tissue plasminogen activator (tPA) antigen levels are a significant and independent prognostic marker in patients with chronic stable heart failure.
  • tPA may serve as a valuable biomarker for risk stratification in heart failure management.

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