Elevated plasma factor XI predicts cardiovascular events in patients with type 2 diabetes: a long-term observational study

Cardiovascular Diabetology

Research

Agata Hanna Bryk-Wiązania¹  Elżbieta Paszek²  Maciej Polak³  Małgorzata Konieczyńska⁴  Anetta Undas⁵ 

[1] Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland;Clinical Department of Interventional Cardiology, John Paul II Hospital, 31-202, Krakow, Poland;Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland;Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland;Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland;Department of Diagnostic Medicine, John Paul II Hospital, 31-202, Krakow, Poland;Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland;Krakow Center for Medical Research and Technologies, John Paul II Hospital, 31-202, Krakow, Poland;

关键词: Factor XI;    Type 2 Diabetes Mellitus;    Myocardial Infarction, Stroke, Cardiovascular Mortality;   

DOI  :  10.1186/s12933-023-01905-5

 received in 2023-05-12, accepted in 2023-06-27,  发布年份 2023

来源: Springer

【 摘 要 】

Background Type 2 diabetes mellitus (T2DM) patients are at high risk of cardiovascular (CV) events. Factor XI (FXI) is associated with arterial thromboembolism, including myocardial infarction (MI), stroke, and CV mortality. The role of FXI in T2DM is unknown. We investigated whether plasma FXI is associated with CV events in T2DM patients in long-term observation.MethodsIn 133 T2DM patients (aged 66 ± 8 years, 40.6% women, median T2DM duration 5 [2–10] years) we assessed plasma FXI levels, along with fibrin clot properties, thrombin generation, and fibrinolysis proteins. A composite endpoint of MI, stroke, or CV death, as well as CV mortality alone were assessed during a median follow-up of 72 months.ResultsPlasma FXI above the 120% upper normal limit was detected in 25 (18.8%) patients and showed positive association with LDL cholesterol and thrombin activatable fibrinolysis inhibitor, but not glycated hemoglobin, inflammatory markers or thrombin generation. The composite endpoint (n = 21, 15.8%) and CV death alone (n = 16, 12%) were more common in patients with elevated FXI (hazard ratio [HR] 10.94, 95% confidence interval [CI] 4.46–26.87, p < 0.001 and HR 7.11, 95% CI 2.61–19.31, p < 0.001, respectively). On multivariable analysis, FXI remained an independent predictor of the composite endpoint and CV death, regardless of concomitant coronary artery disease.ConclusionsTo our knowledge, this study is the first to show that in T2DM patients, elevated FXI could predict major CV events, including mortality, which suggest that anti-FXI agents might be a potential novel antithrombotic option in this disease.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 5