Abstract 13309: Soluble Fibrin Monomer Complex is Associated With Cardio- and Cerebro-vascular Events in Patients With Heart Failure

Abstract

Background: The soluble fibrin monomer complex (SFMC) is a biomarker of fibrin formation, and has been shown to be abnormally elevated in various clinical situations of hypercoagulability. However, the association between SFMC and cardiovascular events in patients with heart failure (HF) remains uncertain. We aimed to examine the prognostic impact of SFMC concerning increased risk of major cardio- and cerebro-vascular events (MACCE) and all-cause mortality in patients with HF. Methods and Results: We conducted a prospective observational study. We analyzed data on 723 hospitalized patients with HF who discharged alive and measured SFMC at stable condition in prior to discharge. Patients were divided into tertiles based on levels of SFMC: 1 st (SFMC <1.7 μg/ml, n = 250), 2 nd (1.8 ≤ SFMC <2.9 μg/ml, n = 233), and 3 rd (3.0 μg/ml ≤ SFMC, n = 240) tertiles. We compared baseline patients’ characteristics and their post-discharge MACCE and mortality. Prevalence of chronic kidney disease (CKD) and anemia was significantly higher in the 3 rd tertile than in the 1 st and 2 nd tertiles. In contrast, age, sex, CHADS 2 -Vasc score, left ventricular ejection fraction, and prevalence of hypertension, diabetes and atrial fibrillation did not differ among the tertiles. During the median follow-up period of 422 days, 61 patients experienced MACCE, and 82 patients died. In the Kaplan-Meier analysis ( Figure ), accumulated event rates of both MACCE and all-cause mortality progressively increased from the 1 st to the 3 rd tertiles (MACCE, 4.8%, 8.6% and 12.1%, log-rank P=0.014; all-cause mortality, 6.4%, 9.4% and 18.3%, log-rank P<0.001). In the multivariable Cox proportional hazard analysis, the 3 rd tertile was found to be an independent predictor of MACCE (HR 2.608, 95%CI 1.331-5.113, P=0.005) and all-cause mortality (HR 2.938, 95%CI 1.657-5.207, P<0.001). Conclusion: SFMC is an independent predictor of adverse prognosis in patients with HF.