ENDOTHELIAL HEMOSTATIC FACTORS MAY BE ASSOCIATED WITH MORTALITY IN PATIENTS ON LONG-TERM ANTICOAGULANT TREATMENT

The aim of the present study was to test if long-term mortality could be predicted by endothelial derived haemostatic variables in a populat ion 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 tis sue plasminogen activator (tPA) and its inhibitor (PAI-1), and von Wil lebrand factor. In the course of 3.8-year follow-up 45 patients died, including 38 vascular deaths. We found that all-cause mortality was si gnificantly associated with increased levels of VWF and tPa. For vascu lar mortality there was a significant association with all three haemo static variables (tPA, PAI-1, vWF). For VWF there was a 3-fold increas e in total and vascular mortality in the highest quartile compared to the lowest quartile. There were 27 vascular deaths in the group of pat ients with a tPA-value above the median compared to 11 in those with a tPA below the median. In multivariate Cox regression analysis (includ ing: age, sex, smoking habits, body mass index, diabetes mellitus, hyp ertension, tPA, PAI-1, and vWF), vWF and smoking were independently si gnificantly associated with all-cause mortality, and tPA and age with vascular mortality. Endothelial derived haemostatic variables are pred ictors of total and vascular mortality in patients treated with oral a nticoagulants.