The prothrombotic potential of diabetic patients with ischemic heart failure is associated with impaired left...

Area of Science:

• Cardiology
• Diabetology
• Hematology

Background:

• Diabetic patients with ischemic heart disease (IHD) and heart failure (HF) present complex cardiovascular challenges.
• Endothelial dysfunction and impaired left ventricular (LV) contractility are common in this population.
• The interplay between HF, diabetes, and thrombotic potential requires further investigation.

Purpose of the Study:

• To investigate associations between LV contractility, endothelial dysfunction, and enhanced thrombin generation in diabetic patients with ischemic HF.
• To compare fibrin clot properties in diabetic patients with and without HF.
• To determine if HF diagnosis correlates with altered thrombin generation and fibrin clot characteristics.

Main Methods:

• Study included 85 HF patients with type 2 diabetes (T2DM) and IHD, categorized by LV ejection fraction (LVEF) into HFrEF (<40%) and HFpEF (≥50%).
• A control group (n=43) comprised diabetic IHD participants without HF (non-HF).
• Assessed endogenous thrombin potential (ETP), fibrin clot permeability (Ks), flow-mediated dilation (FMD), and nitroglycerin-mediated dilatation (NMD).

Main Results:

• HF patients (HFrEF and HFpEF) demonstrated less permeable fibrin clots compared to non-HF controls.
• HFrEF patients showed higher ETP, lower Ks, and reduced NMD compared to HFpEF patients.
• Multivariable analysis indicated that lower LVEF, reduced NMD, and elevated total cholesterol influenced enhanced ETP in the HF population.

Conclusions:

• Heart failure diagnosis in diabetic patients with IHD is associated with denser fibrin clots.
• HF patients with reduced LVEF exhibit greater thrombin generation and reduced clot permeability than those with preserved LVEF.
• Impaired LV systolic and vascular vasodilator function contribute to enhanced thrombin generation in HF.