Relative Influence of Age and Thrombotic History on Hemostatic Parameters
1998; Elsevier BV; Volume: 91; Issue: 5 Linguagem: Inglês
10.1016/s0049-3848(98)00104-2
ISSN1879-2472
AutoresSandrine Javorschi, S. Richard‐Harston, Sylvie Labrouche, G Manciet, G. Freyburger,
Tópico(s)Blood properties and coagulation
ResumoAcquired alterations in hemostatic parameters can be the result of both thrombotic events and aging. Indeed, aging is associated with an increased risk of deep venous thrombosis (DVT) and ischemic stroke (IS), which may be due to physiological alterations of the hemostatic system or the vessel wall. Moreover, the incidence of predisposing conditions (hypertension, immobility, malignancies, surgery) increases with age. Table 1 summarizes several studies reporting influence of aging or of thrombotic events on hemostasis parameters, but no study has considered both aging and thrombotic events together in a large assay of variables assessing inflammation, activation of coagulation, anticoagulation, and fibrinolysis. Aging-related alterations have been studied in healthy subjects [ 1 Hamilton P.J. Allardyce M. Ogstn D. Dawson A.A. Douglas A.S. The effect of age upon the coagulation system. J Clin Pathol. 1974; 27: 980-982 Crossref PubMed Scopus (49) Google Scholar , 2 Balleisen L. Bailey J. Epping P.H. Schutle H. Van de Loo J. Epidemiological study on factor VII, factor VIII, and fibrinogen in an industrial population, I Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill using, and menopause. Thromb Haemost. 1985; 54: 475-479 PubMed Google Scholar , 3 Aillaud M.F. Pignol F. Alessi M.C. Harle J.R. Escande M. Mongin M. Juhan-Vague I. Increase in plasma concentration of plasminogen activator inhibitor, fibrinogen, von Willebrand factor, factor VIIIc and erythrocyte sedimentation rate with age. Thromb Haemost. 1986; 55: 330-332 PubMed Google Scholar , 4 Bauer K.A. Weiss L.M. Sparrow D. Vokonas P.S. Rosenberg R.D. Aging-associated changes in indices of thrombin generation and protein C activation in humans. Normative aging study. J Clin Invest. 1987; 80: 1527-1534 Crossref PubMed Scopus (209) Google Scholar , 5 Folsom A. Wu K. Davis C. Conlan M. Sorlie P. Szklo M. Population correlates of plasma fibrinogen and factor VII, putative cardiovascular risk factors. Atherosclerosis. 1991; 91: 191-205 Abstract Full Text PDF PubMed Scopus (341) Google Scholar , 6 Tracy R.P. Bovill E.G. Thrombosis and cardiovascular risk in the elderly. Arch Pathol Lab Med. 1992; 116: 1307-1312 PubMed Google Scholar , 7 Tracy R.P. Bovill E.G. Fried L.P. Heiss G. Lee M.H. Polak J.F. Psaty B.M. Savage P.J. The distribution of coagulation factors VII, VIII, and fibrinogen in adults over the age of 65 years Results from the Cardiovascular Health Study. Ann Epidemiol. 1992; 2: 509-519 Abstract Full Text PDF PubMed Scopus (73) Google Scholar , 8 Lowe G.D. Rumley A. Woodward M. Morrisson C.E. Philippou H. Lane D.A. Tunstall-Pedoe H. Epidemiology of coagulation factors, inhibitors and activation markers The Third Glasgow MONICA survey. I. Illustrative references ranges by age, sex and hormone use. Br J Haematol. 1997; 4: 775-784 Crossref Scopus (259) Google Scholar ] while alterations related to thrombotic events have mostly been studied in young patients (less than 45 [ 8 Lowe G.D. Rumley A. Woodward M. Morrisson C.E. Philippou H. Lane D.A. Tunstall-Pedoe H. Epidemiology of coagulation factors, inhibitors and activation markers The Third Glasgow MONICA survey. I. Illustrative references ranges by age, sex and hormone use. Br J Haematol. 1997; 4: 775-784 Crossref Scopus (259) Google Scholar ] or 60 years old [ 10 Meade T.W. Mellows S. Brozovic M. Miller G.J. Chakrabarti R.R. North W.R. Haines A.P. Stirling Y. Imeson I.D. Thompson S.G. Hemostatic function and ischaemic heart disease Principal results of the Northwick Park Heart Study. Lancet. 1986; 9: 533-537 Abstract Scopus (1962) Google Scholar ]), except for fibrinogen and VIIIc in the Framingham Study [ 11 Kannel W.B. Wolf P.A. Castelli W.P. d'Agostino R.B. Fibrinogen and risk of cardiovascular disease; the Framingham Study. JAMA. 1987; 258: 1183-1186 Crossref PubMed Scopus (1494) Google Scholar ], which includes patients aged from 35 to 94 years. Generally, these studies only concern arterial diseases [ 9 Hamsten A. Blombäck M. Wiman B. Svensson J. Szamosi A. de Faire U. Mettinger L. Hemostatic function in myocardial infarction. Br Heart J. 1986; 55: 58-66 Crossref PubMed Scopus (163) Google Scholar , 10 Meade T.W. Mellows S. Brozovic M. Miller G.J. Chakrabarti R.R. North W.R. Haines A.P. Stirling Y. Imeson I.D. Thompson S.G. Hemostatic function and ischaemic heart disease Principal results of the Northwick Park Heart Study. Lancet. 1986; 9: 533-537 Abstract Scopus (1962) Google Scholar , 11 Kannel W.B. Wolf P.A. Castelli W.P. d'Agostino R.B. Fibrinogen and risk of cardiovascular disease; the Framingham Study. JAMA. 1987; 258: 1183-1186 Crossref PubMed Scopus (1494) Google Scholar , 12 Hamsten A. de Faire U. Walldius G. Dahlen G. Szamosi A. Landou C. Blombäck M. Wiman B. Plasminogen activator inhibitor in plasma Risk factor for recurrent myocardial infarction. Lancet. 1987; 2: 3-9 Abstract PubMed Scopus (1450) Google Scholar ]. Moreover, studies of venous thrombosis risk generally focus on alterations in physiological anticoagulants. Fibrinogen, vWF and plasminogen activator inhibitor-1 (PAI-1) have been more studied with regard to arterial risk than with regard to venous thrombosis, although they may also be involved in the latter. One explanation is that arterial pathologies are treated in specific medical care units whereas venous pathologies are usually diagnosed in many different types of unit. Studying the incidence of age and thrombotic events on hemostatic alterations, either venously or arterially localized, may thus throw light both on base-line values and thrombosis-related alterations. Indeed, recognizing thrombosis-associated changes in hemostasis in elderly subjects implies that "physiological changes" have been previously identified to constitute a base-line pattern in elderly subjects, thereby enabling additional alterations to be determined. The present study was thus undertaken to establish the relative weight of aging itself and thrombotic events in the hemostatic changes observed, by selecting different groups of patients of varying age (elderly vs. young) and clinical history (thrombosis or not). Table 1Studies from the literature on effects of aging and thrombotic events on hemostasis parameters legend DVT, deep venous thrombosis; PE, pulmonary embolism. Population characteristics Author, year, reference number Influenced factors and main ideas Health status Number (men/women) Range of age (years) Hamilton et al., 1974 1 Hamilton P.J. Allardyce M. Ogstn D. Dawson A.A. Douglas A.S. The effect of age upon the coagulation system. J Clin Pathol. 1974; 27: 980-982 Crossref PubMed Scopus (49) Google Scholar X, VII, V: increased with age Healthy 10/10 20–40 Balleisen et al., 1985 2 Balleisen L. Bailey J. Epping P.H. Schutle H. Van de Loo J. Epidemiological study on factor VII, factor VIII, and fibrinogen in an industrial population, I Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill using, and menopause. Thromb Haemost. 1985; 54: 475-479 PubMed Google Scholar VII, VIIIc, Fg: increased with age Healthy 2880/1306 All ranges of age Aillaud et al., 1986 3 Aillaud M.F. Pignol F. Alessi M.C. Harle J.R. Escande M. Mongin M. Juhan-Vague I. Increase in plasma concentration of plasminogen activator inhibitor, fibrinogen, von Willebrand factor, factor VIIIc and erythrocyte sedimentation rate with age. Thromb Haemost. 1986; 55: 330-332 PubMed Google Scholar PAI-1, Fg, vWF, VIIIc: increased with age Healthy 10/10 10/10 20–28 70–97 Bauer et al., 1987 4 Bauer K.A. Weiss L.M. Sparrow D. Vokonas P.S. Rosenberg R.D. Aging-associated changes in indices of thrombin generation and protein C activation in humans. Normative aging study. J Clin Invest. 1987; 80: 1527-1534 Crossref PubMed Scopus (209) Google Scholar F1+2: increased with age ATIII, PC: no variation Healthy 199 42–80 Folsom et al., 1991 5 Folsom A. Wu K. Davis C. Conlan M. Sorlie P. Szklo M. Population correlates of plasma fibrinogen and factor VII, putative cardiovascular risk factors. Atherosclerosis. 1991; 91: 191-205 Abstract Full Text PDF PubMed Scopus (341) Google Scholar Fg, VII: increased with age Healthy 12000/12000 45–64 Tracy et al., 1992 6 Tracy R.P. Bovill E.G. Thrombosis and cardiovascular risk in the elderly. Arch Pathol Lab Med. 1992; 116: 1307-1312 PubMed Google Scholar , 7 Tracy R.P. Bovill E.G. Fried L.P. Heiss G. Lee M.H. Polak J.F. Psaty B.M. Savage P.J. The distribution of coagulation factors VII, VIII, and fibrinogen in adults over the age of 65 years Results from the Cardiovascular Health Study. Ann Epidemiol. 1992; 2: 509-519 Abstract Full Text PDF PubMed Scopus (73) Google Scholar Fg, VII and PAI-1: increased with age Healthy 2106/2724 65–100 Lowe et al., 1997 8 Lowe G.D. Rumley A. Woodward M. Morrisson C.E. Philippou H. Lane D.A. Tunstall-Pedoe H. Epidemiology of coagulation factors, inhibitors and activation markers The Third Glasgow MONICA survey. I. Illustrative references ranges by age, sex and hormone use. Br J Haematol. 1997; 4: 775-784 Crossref Scopus (259) Google Scholar Increases in coagulation factors (Fg, VII, VIIIc, IX) with age greater than increases of coagulation inhibitors (ATIII, PC, PS) Healthy 747/817 25–74 Hamsten et al., 1986 9 Hamsten A. Blombäck M. Wiman B. Svensson J. Szamosi A. de Faire U. Mettinger L. Hemostatic function in myocardial infarction. Br Heart J. 1986; 55: 58-66 Crossref PubMed Scopus (163) Google Scholar Fg and PAI1: elevated in male pa- tients VIIIc, vWF, PAI: elevated in female patients Myocardial infarction Healthy 116/32 136/136 <45 <45 Meade et al., 1986 10 Meade T.W. Mellows S. Brozovic M. Miller G.J. Chakrabarti R.R. North W.R. Haines A.P. Stirling Y. Imeson I.D. Thompson S.G. Hemostatic function and ischaemic heart disease Principal results of the Northwick Park Heart Study. Lancet. 1986; 9: 533-537 Abstract Scopus (1962) Google Scholar Increased Fg level associated with increased risk of ischemic heart disease Ischemic heart disease 109 45–60 Kannel et al., 1987 11 Kannel W.B. Wolf P.A. Castelli W.P. d'Agostino R.B. Fibrinogen and risk of cardiovascular disease; the Framingham Study. JAMA. 1987; 258: 1183-1186 Crossref PubMed Scopus (1494) Google Scholar Increased Fg level significantly associated with incidence of cardiovascular disease Cardiovascular diseases 165/147 35–94 Hamsten et al., 1987 12 Hamsten A. de Faire U. Walldius G. Dahlen G. Szamosi A. Landou C. Blombäck M. Wiman B. Plasminogen activator inhibitor in plasma Risk factor for recurrent myocardial infarction. Lancet. 1987; 2: 3-9 Abstract PubMed Scopus (1450) Google Scholar Decrease in fibrinolytic capacity due to increased plasma levels of PAI predisposes to reinfarction Myocardial infarction 109 60 >60 legend DVT, deep venous thrombosis; PE, pulmonary embolism. Open table in a new tab
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