LOW LEVELS OF COAGULATION FACTOR XI AND XII IN CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION COMPARED WITH PUMONARY EMBOLISM

Abstract

TYPE: Late Breaking Abstract TOPIC: Pulmonary Vascular Disease PURPOSE: We aimed to explore the difference of coagulation factor XI and XII in chronic thromboembolic pulmonary hypertension (CTEPH), pulmonary embolism (PE) and idiopathic pulmonary arterial hypertension (IPAH). METHODS: The retrospectively cross-sectional study included 316 patients from June 2013 to June 2017. Plasma activity of factor XI and XII were measured and compared in 111 CTEPH patients, 82 APE survivors, who have not developed chronic pulmonary hypertension after at least 2 years from the acute episode, and123 IPAH patients. All the clinical and laboratory profiles were documented after a full anti-coagulation therapy at least for 3 months in PE and CTEPH patients. RESULTS: In CTEPH patients, factor XI activity was significant lower than in PE patients (P<0.001) and IPAH group (P<0.001), while PE was higher than IPAH patients. Factor XII activity of CTEPH was lower than PE patients’ (P<0.001) while comparable to IPAH. Receiver-operating characteristic curves showed the great performance of factor XI and XII activity in distinguishing PE from CTEPH. Besides, Adjustment for age, gender, BMI, antiphospholipid antibody syndrome, autoimmune diseases, thyroid replacement therapy, splenectomy, and blood group didn’t change the effect size of every 10% increase of factor XI and XII activity for risk of CTEPH (OR = 0.78, 95%Cl 0.70-0.87 and 0.90, 95%Cl 0.83-0.98). CONCLUSIONS: Plasma XI and XII activity seems to represent important factors in CTEPH pathophysiology and may have been continuously consumed during the whole process of its pathophysiology, which may contribute to the clinical diagnosis and therapy. CLINICAL IMPLICATIONS: This results may contribute to the clinical diagnosis and therapy. DISCLOSURE: Nothing to declare. KEYWORD: FACTOR XI; FACTOR XII; CTEPH; PULMONARY EMBOLISM