Soluble fibrin monomer complex is associated with cardio- and cerebrovascular events in patients with heart failure. (February 2021)

• Record Type: Journal Article
• Authors: Yoshihisa, Akiomi; Sato, Yu; Kimishima, Yusuke; Ichijo, Yasuhiro; Yokokawa, Tetsuro; Misaka, Tomofumi; Sato, Takamasa; Oikawa, Masayoshi; Kobayashi, Atsushi; Nakazato, Kazuhiko; Takeishi, Yasuchika
• Is Part Of: IJC heart & vasculature. Volume 32(2021)
• Publication Date: 2021-02
• Subjects: Heart failure -- Fibrin formation -- Hypercoagulability -- Major cardio- and cerebrovascular events -- Prognosis; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2020.100697
• Languages: English
• ISSNs: 2352-9067

Abstract

Highlights: The soluble fibrin monomer complex (SFMC), is a marker of fibrin formation. SFMC is abnormally elevated in a variety of clinical situations of hypercoagulability. SFMC is an independent predictor of adverse prognosis in patients with heart failure. Abstract: Background: A biomarker of fibrin formation, the soluble fibrin monomer complex (SFMC), is abnormally elevated in a variety of clinical situations of hypercoagulability. The aim of the present study was to examine the prognostic impact of SFMC, with regard to increased risk of major cardio- and cerebrovascular events (MACCE) and all-cause mortality, on patients with heart failure (HF). Methods and Results: We conducted a prospective observational study where we analyzed data of 723 hospitalized patients with decompensated HF who were discharged alive and whose SFMC had been measured in a stable condition prior to discharge. The patients were divided into tertiles based on SFMC levels: the first (SFMC < 1.7 μg/ml, n = 250), second (≤1.8 SFMC < 2.9 μg/ml, n = 233), and third (3.0 μg/ml ≤ SFMC, n = 240) tertiles. The prevalence of chronic kidney disease and anemia was significantly higher in the third tertile than in the first and second tertiles. In contrast, age, sex, CHADS2 -Vasc score, left ventricular ejection fraction, and prevalence of hypertension, diabetes and atrial fibrillation did not differ among the tertiles. In the Kaplan-Meier analysis, accumulated event rates of both MACCE and all-cause mortality progressively increased from the first to third tertiles (log-rank P < 0.05, respectively). In the multivariate Cox proportional hazard analysis, the third tertile was found to be an independent predictor of MACCE (HR 2.014, P = 0.046) and all-cause mortality (HR 1.792, P = 0.036). Conclusion: SFMC is an independent predictor of adverse prognosis in patients with HF.