Endothelial haemostatic factors may be associated with mortality in patients on long-term anticoagulant treatment

Thromb Haemost. 1995 Aug;74(2):612-5.

Abstract

The aim of the present study was to test if long-term mortality could be predicted by endothelial derived haemostatic variables in a population with high morbidity due to thromboembolic disease. Plasma samples were drawn from 212 out-patients treated with oral anticoagulants, at the beginning of the study, and analyzed for mass concentration of tissue plasminogen activator (tPA) and its inhibitor (PAI-1), and von Willebrand factor. In the course of 3.8-year follow-up 45 patients died, including 38 vascular deaths. We found that all-cause mortality was significantly associated with increased levels of vWF and tPA. For vascular mortality there was a significant association with all three haemostatic variables (tPA, PAI-1, vWF). For vWF there was a 3-fold increase in total and vascular mortality in the highest quartile compared to the lowest quartile. There were 27 vascular deaths in the group of patients with a tPA-value above the median compared to 11 in those with a tPA below the median. In multivariate Cox regression analysis (including: age, sex, smoking habits, body mass index, diabetes mellitus, hypertension, tPA, PAI-1, and vWF), vWF and smoking were independently significantly associated with all-cause mortality, and tPA and age with vascular mortality. Endothelial derived haemostatic variables are predictors of total and vascular mortality in patients treated with oral anticoagulants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticoagulants / therapeutic use*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / physiopathology
  • Cause of Death
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Endothelium, Vascular / physiopathology*
  • Follow-Up Studies
  • Hemostasis*
  • Humans
  • Hypertension / epidemiology
  • Obesity / epidemiology
  • Plasminogen Activator Inhibitor 1 / analysis*
  • Proportional Hazards Models
  • Risk Factors
  • Smoking / epidemiology
  • Thromboembolism / drug therapy*
  • Tissue Plasminogen Activator / analysis*
  • von Willebrand Factor / analysis*

Substances

  • Anticoagulants
  • Plasminogen Activator Inhibitor 1
  • von Willebrand Factor
  • Tissue Plasminogen Activator