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Thromb Haemost 2015; 114(01): 123-132
DOI: 10.1160/TH14-11-0952
Cellular Signalling and Proteolysis
Schattauer GmbH

Factor XIII-A dynamics in acute myocardial infarction: a novel prognostic biomarker?

Donato Gemmati
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Giulia Zeri
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Elisa Orioli
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Rosella Mari
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Stefano Moratelli
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Marco Vigliano
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Jlenia Marchesini
2   Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
,
Maria Elena Grossi
2   Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
,
Alessandro Pecoraro
2   Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
,
Antonio Cuneo
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Roberto Ferrari
3   Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care&Research, E.S: Health Science Foundation, Cotignola, Italy
,
Mirko Pinotti
4   Department of Life Sciences and Biotechnology; University of Ferrara, Italy
,
Luisa M. Serino
1   Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
,
Lucia Ansani
2   Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
› Author Affiliations Financial support: The present project has been funded by ALT (Italian Association Against Thrombosis and Cardiovascular Disease) and Italian MIUR.
Further Information

Publication History

Received: 17 November 2014

Accepted after major revision: 23 February 2015

Publication Date:
22 November 2017 (online)

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Summary

After acute myocardial infarction (MI) the damaged heart has to be repaired. Factor XIII (FXIII) is considered a key molecule in promoting heart healing. FXIII deficiency was associated to cardiac rupture and anomalous remodelling in MI. During MI, FXIII contributes firstly to the intracoronary thrombus formation and shortly after to heal the myocardial lesion. To quantify the real contribution of FXIII in this process, and to explore its possible prognostic role, we monitored the FXIII-A subunit levels in 350 acute MI patients during the first six days (d0-d5) plus a control at 30–60 days (d30). A one-year follow-up was performed for all the patients. A transient drop in the FXIII-A mean level was noted in the whole cohort of patients (FXIII-Ad0 99.48 ± 30.5 vs FXIII-Ad5 76.51 ± 27.02; p< 0.0001). Interestingly, those who developed post-MI heart failure showed the highest drop (FXIII-Ad5 52.1 ± 25.2) and they already presented with low levels at recruitment. Similarly, those who died showed the same FXIII-A dynamic (FXIII-Ad5 54.0 ± 22.5). Conversely, patients who remained free of major adverse cardiac events, had lower consuming (FXIII-Ad0 103.6 ± 29.1 vs FXIII-Ad5 84.4 ± 24.5; p< 0.0001). Interestingly, the FXIII-A drop was independent from the amount of injury assessed by TnT and CKMB levels. The survival analysis ascribed an increased probability of early death or heart failure inversely related to FXIII-A quartiles (FXIII-A25th< 59.5 %; hazard ratio 4.25; 2.2–5.1; p< 0.0001). Different FXIII-A dynamics and levels could be utilised as early prognostic indicators during acute MI, revealing the individual potential to heal and suggesting tailored treatments to avoid heart failure or its extreme consequence.

Note: This paper was presented in part at the 14th Congress of the International Society on Thrombosis and Haemostasis, Amsterdam, Netherlands, June 29 – July 24, 2013.

Keywords

Factor XIII - myocardial infarction - myocardial healing - prognosis - myocardial infarction biomarkers

 

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