Symptom Duration Is Positively Correlated with Factor XIIIa Activity in Acute Pulmonary Embolism

Abstract

BackgroundAcute pulmonary embolism (PE) patients are at variable risk of morbidity, mortality, and response to therapy. Patients often present at various time points from the symptom onset. Several factors may shed light into the state of endogenous thrombotic and fibrinolytic system at the time of presentation. Factor XIIIa plays a critical role in clot stabilization and may impact clot dissolution. Relation of Factor XIIIa activity and symptom duration is not known.MethodsWe prospectively collected blood samples from patients evaluated by Pulmonary Embolism Response Team at a tertiary care center. Blood was centrifuged, and plasma collected for analysis. We used ELISA method utilizing a commercially available kit from Hyphen, BioMed (Neuville-sur-Oise France), specific for measurement of Factor XIIIa, D-dimer, and Pro-TAFI antigens.Baseline clinical characteristics were collected from electronic medical record. Symptom duration was gathered from patient subjective assessment. Additional workup included radiographic and echocardiographic evaluation.We performed correlation analysis to test the association between symptom duration and Factor XIIIa activity, D-dimer, and Pro-TAFI antigen. Additionally we performed linear regression analyses to quantify the degree of association of symptom duration and Factor XIIIa activity.Results±±9.8, 8 patients were treated with catheter directed thrombolysis, while the rest were treated with anticoagulation alone. Symptom duration was positively correlated with Factor XIIIa activity (r2=0.227). More so, for every one day increase in symptom duration the Factor XIIIa activity was increased by 2.2%. (p=0.014). We demonstrated no correlation between symptom duration and D-Dimer (p=0.58) or symptom duration and Pro-TAFI antigen (p=0.84).ConclusionIn patients with acute PE, symptom duration positively correlated with Factor XIIIa activity, for every one day increase in symptom duration the Factor XIIIa activity was increased by 2.2%. Future studies are needed to ascertain the impact of Factor XIIIa activity and clot dissolution as well as functional outcomes. DisclosuresNo relevant conflicts of interest to declare.