Thromb Haemost 2020; 120(01): 181-183
DOI: 10.1055/s-0039-1697956
Letter to the Editor
Georg Thieme Verlag KG Stuttgart · New York

Fibrin Clot Properties and Thrombin Generation in Hypertrophic Cardiomyopathy

Paweł Rubiś
1  Department of Cardiac and Vascular Diseases, Jagiellonian University Collegium Medicum, John Paul II Hospital, Kraków, Poland
2  Institute of Cardiology, Jagiellonian University Medical College, Jagiellonian University, Krakow, Poland
,
Joanna Natorska
2  Institute of Cardiology, Jagiellonian University Medical College, Jagiellonian University, Krakow, Poland
3  Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland
,
Michał Ząbczyk
2  Institute of Cardiology, Jagiellonian University Medical College, Jagiellonian University, Krakow, Poland
3  Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland
,
Ewa Dziewięcka
1  Department of Cardiac and Vascular Diseases, Jagiellonian University Collegium Medicum, John Paul II Hospital, Kraków, Poland
,
Aleksandra Karabinowska
1  Department of Cardiac and Vascular Diseases, Jagiellonian University Collegium Medicum, John Paul II Hospital, Kraków, Poland
,
Sylwia Wiśniowska-Śmiałek
1  Department of Cardiac and Vascular Diseases, Jagiellonian University Collegium Medicum, John Paul II Hospital, Kraków, Poland
,
Ann C. Garlitski
4  New England Cardiac Arrhythmia Center, Tufts Medical Center Boston, Massachusetts, United States
,
Piotr Podolec
1  Department of Cardiac and Vascular Diseases, Jagiellonian University Collegium Medicum, John Paul II Hospital, Kraków, Poland
2  Institute of Cardiology, Jagiellonian University Medical College, Jagiellonian University, Krakow, Poland
,
Anetta Undas
2  Institute of Cardiology, Jagiellonian University Medical College, Jagiellonian University, Krakow, Poland
3  Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland
› Author Affiliations
Funding This work was supported by the Department of Scientific Research and Structural Funds of Medical College, Jagiellonian University (grant K/ZDS/007912).
Further Information

Publication History

08 August 2019

21 August 2019

Publication Date:
28 October 2019 (online)

Introduction

Although most patients with hypertrophic cardiomyopathy (HCM) are oligosymptomatic with normal life expectancy, approximately one-fifth experience increased morbidity and mortality.[1] There are a wide range of clinical manifestations of HCM including diastolic dysfunction, end-stage heart failure (HF), ischemia, left ventricular outflow tract (LVOT) obstruction, atrial fibrillation (AF), syncope, and sudden cardiac death (SCD). Thromboembolic (TE) events such as stroke are observed predominantly in patients with AF.[1] [2] In a landmark study, TE complications were reported in 51 (6%) out of 900 ambulatory HCM patients over a period of 7 ± 7 years with an overall incidence of 0.8%/year and 1.9% for those > 60 years old. The independent predictors of TE complications were found to be AF, age, and HF. Of note, in 6 (12%) patients with TE complications, the etiology was not established.[3]

Hypercoagulation has been demonstrated previously in HCM. However, blood coagulopathies in HCM patients have been poorly explored.[4] An unfavorable fibrin clot phenotype, including the formation of dense and poorly lysable clots, has been reported in patients with TE events.[5] Prothrombotic features have been demonstrated in AF patients with an increased risk of stroke.[6] It is unknown whether HCM per se predisposes to a prothrombotic state. We investigated fibrin clotting properties and thrombin generation parameters in HCM patients without concomitant AF.