Background: Thrombin generation (TG) is used as a global test of coagulation, and is an indicator of thrombosis and bleeding risk. Until now, data on the association of TG and mortality is inconclusive. We investigated the association of TG and mortality in the prospective Moli-sani cohort (n=21,920). Methods: TG was measured using calibrated automated thrombinography using PPP reagent low. Lag time (LT), endogenous thrombin potential (ETP), peak height, time-to-peak (TTP) and velocity index (VI) were quantified. The association of TG and mortality was studied by Cox regression, and adjusted for sex, age, BMI, smoking, contraceptives and medical history (cardiovascular diseases, hypertension, hypercholesterolemia, diabetes and cancer). Results: LT and TTP were 4.1 ± 1.0 min and 6.6 ± 1.5 min, on average. The peak height was 364±88 nM, VI was 163±63 nM/min and ETP was 1721 ± 411 nM·min. ETP was negatively associated with all-cause mortality (HR: 0.86; CI: 0.81-0.92; p<0.001). Subjects in the lowest quintile of the ETP (ETPQ1) had a 1.3-fold higher mortality rate. Additionally, a high TTP/LT ratio was negatively associated with mortality (HR: 0.71; CI:0.57-0.89; p=0.003). Individuals in quintile 1 of the TTP/LT ratio had a 1.4-fold higher mortality rate compared to the remainder of the cohort. Subjects that were both in ETPQ1 and TTP/LTQ1 had a 1.8-fold higher mortality rate, regardless of whether they reported history of cardiovascular disease (CVD) at baseline (HR: 1.61 [1.07-2.42]) or not (HR: 1.89 [1.51-2.36]). Conclusion: Low ETP and TTP/LT ratio are independent risk factors forall-cause mortality in the general population.
Endogenous Thrombin Potential and Time-Dependent Thrombin Generation Parameters are Independent Risk Factors for Mortality in the General Population
Iacoviello, Licia
2024-01-01
Abstract
Background: Thrombin generation (TG) is used as a global test of coagulation, and is an indicator of thrombosis and bleeding risk. Until now, data on the association of TG and mortality is inconclusive. We investigated the association of TG and mortality in the prospective Moli-sani cohort (n=21,920). Methods: TG was measured using calibrated automated thrombinography using PPP reagent low. Lag time (LT), endogenous thrombin potential (ETP), peak height, time-to-peak (TTP) and velocity index (VI) were quantified. The association of TG and mortality was studied by Cox regression, and adjusted for sex, age, BMI, smoking, contraceptives and medical history (cardiovascular diseases, hypertension, hypercholesterolemia, diabetes and cancer). Results: LT and TTP were 4.1 ± 1.0 min and 6.6 ± 1.5 min, on average. The peak height was 364±88 nM, VI was 163±63 nM/min and ETP was 1721 ± 411 nM·min. ETP was negatively associated with all-cause mortality (HR: 0.86; CI: 0.81-0.92; p<0.001). Subjects in the lowest quintile of the ETP (ETPQ1) had a 1.3-fold higher mortality rate. Additionally, a high TTP/LT ratio was negatively associated with mortality (HR: 0.71; CI:0.57-0.89; p=0.003). Individuals in quintile 1 of the TTP/LT ratio had a 1.4-fold higher mortality rate compared to the remainder of the cohort. Subjects that were both in ETPQ1 and TTP/LTQ1 had a 1.8-fold higher mortality rate, regardless of whether they reported history of cardiovascular disease (CVD) at baseline (HR: 1.61 [1.07-2.42]) or not (HR: 1.89 [1.51-2.36]). Conclusion: Low ETP and TTP/LT ratio are independent risk factors forall-cause mortality in the general population.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
