Abstract 12360: Association of Coagulation Factor XI Levels With Cardiac Function and Cardiovascular Events: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Coagulation Factor XI (FXI) inhibitors are a promising and novel class of anticoagulants, but a recent animal study showed that FXI has an anti-fibrotic role that ameliorated diastolic dysfunction and heart failure (HF). Whether FXI levels are associated with cardiac function and cardiovascular (CV) events in humans is unknown. Hypothesis: We hypothesize that lower FXI levels are associated with worse cardiac function and higher risk of CV events (HF and atrial fibrillation [AF]). Methods: We included 4,471 participants (mean age 75 years, 57% female, 17% Black) who attended ARIC Visit 5 (2011-2013) with plasma FXI measured by Somalogic and cardiac function measured by echocardiography. HF and AF events were ascertained through 2019. Linear regression was used to assess the association between FXI and cardiac function measures. Logistic regression and Cox proportional hazard model were used to examine the association of FXI levels with prevalent and incident HF and AF, respectively. Result: At baseline, there were 665 and 419 participants with prevalent HF and AF; over a median follow-up of 7 years, there were 643 and 415 incident HF and AF events. Among cardiac function measures, we found significant associations between FXI level and E/A ratio, left atrial (LA) volume index, LA reservoir strain, and LA contractile strain, but not E/e’ ratio, LA conduit strain, left ventricular (LV) ejection fraction or LV global longitudinal strain (Table). Lower FXI levels was associated with a higher odds of prevalent AF but not prevalent HF (Table). No significant associations were found between FXI levels and incident HF or AF. Conclusion: Lower FXI levels are associated with worse diastolic function, LA function and size, and prevalent AF, but not LV systolic function, prevalent HF, or incident HF or AF. More research is needed to assess unwanted effects of FXI inhibition on cardiac function and risk of CV events.