Effects of Aging on the Coagulation Fibrinolytic System in Outpatients of the Cardiovascular Department

Background: Although clinical trials demonstrate that the elderly with atrial fibrillation have risks of thrombosis and bleeding, the relationship between aging and coagulation fibrinolytic system in "real-world" cardiology outpatients is uncertain. Methods and Results: We retrospectively evaluated 773 patients (mean age: 58 years; 52% men; Asian ethnicity). To thoroughly investigate markers of coagulation and fibrinolysis, we simultaneously measured levels of D-dimer, prothrombin-fragment1+2 (F1+2), plasmin-alpha 2 plasmin inhibitor complex (PIC), and thrombomodulin (TM). There were correlations between aging and levels of F1+2, D-dimer, PIC, and TM (R=0.61, 0.57, 0.49, and 0.30, respectively). We compared 3 age groups, which were defined as the Y group (<64 years), M group (65-74 years), and the O group (>75 years). Levels of markers were higher in older individuals (D-dimer: 1.0+/-0.8 vs. 0.8+/-0.8 vs. 0.6+/-0.4 mu g/ml, F1+2: 281.8+/-151.3 vs. 224.6+/-107.1 vs. 155.5+/-90.0 pmol/L, PIC: 0.9+/-0.3 vs. 0.8+/-0.3 vs. 0.6+/-0.5 mu g/ml, and TM: 2.9+/-0.8 vs. 2.7+/-0.7 vs. 2.5+/-0.7FU/ml). We performed logistic regression analysis to determine F1+2 and PIC levels. Multivariate analysis revealed that aging was the most important determinant of high F1+2 and PIC levels. Conclusions: Hypercoagulable states develop with advancing age in "real-world" cardiology outpatients.