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Hörber, S. ; Prystupa, K.* ; Jacoby, J.* ; Fritsche, A. ; Kleber, M.E.* ; Moissl, A.P.* ; Hellstern, P.A.* ; Peter, A. ; März, W.* ; Wagner, R.* ; Heni, M.*

Blood coagulation in Prediabetes clusters-impact on all-cause mortality in individuals undergoing coronary angiography.

Cardiovasc. Diabetol. 23:306 (2024)
Publ. Version/Full Text DOI PMC
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BACKGROUND: Metabolic clusters can stratify subgroups of individuals at risk for type 2 diabetes mellitus and related complications. Since obesity and insulin resistance are closely linked to alterations in hemostasis, we investigated the association between plasmatic coagulation and metabolic clusters including the impact on survival. METHODS: Utilizing data from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, we assigned 917 participants without diabetes to prediabetes clusters, using oGTT-derived glucose and insulin, high-density lipoprotein cholesterol, triglycerides, and anthropometric data. We performed a comprehensive analysis of plasmatic coagulation parameters and analyzed their associations with mortality using proportional hazards models. Mediation analysis was performed to assess the effect of coagulation factors on all-cause mortality in prediabetes clusters. RESULTS: Prediabetes clusters were assigned using published tools, and grouped into low-risk (clusters 1,2,4; n = 643) and high-risk (clusters 3,5,6; n = 274) clusters. Individuals in the high-risk clusters had a significantly increased risk of death (HR = 1.30; CI: 1.01 to 1.67) and showed significantly elevated levels of procoagulant factors (fibrinogen, FVII/VIII/IX), D-dimers, von-Willebrand factor, and PAI-1, compared to individuals in the low-risk clusters. In proportional hazards models adjusted for relevant confounders, elevated levels of fibrinogen, D-dimers, FVIII, and vWF were found to be associated with an increased risk of death. Multiple mediation analysis indicated that vWF significantly mediates the cluster-specific risk of death. CONCLUSIONS: High-risk prediabetes clusters are associated with prothrombotic changes in the coagulation system that likely contribute to the increased mortality in those individuals at cardiometabolic risk. The hypercoagulable state observed in the high-risk clusters indicates an increased risk for cardiovascular and thrombotic diseases that should be considered in future risk stratification and therapeutic strategies.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Cluster ; Coagulation ; Mortality ; Prediabetes; Von-willebrand-factor; Plasminogen-activator Inhibitor-1; Factor Plasma-levels; Cardiovascular-disease; Insulin-resistance; Factor-viii; Endothelial Dysfunction; Myocardial-infarction; Elevated Levels; Adipose-tissue
Language english
Publication Year 2024
HGF-reported in Year 2024
ISSN (print) / ISBN 1475-2840
e-ISSN 1475-2840
Journal Cardiovascular Diabetology
Quellenangaben Volume: 23, Issue: 1, Pages: , Article Number: 306 Supplement: ,
Publisher BioMed Central
Publishing Place Campus, 4 Crinan St, London N1 9xw, England
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
POF-Topic(s) 90000 - German Center for Diabetes Research
Research field(s) Helmholtz Diabetes Center
PSP Element(s) G-502400-001
Grants Universittsklinikum Tbingen (8868)
DOI 10.1186/s12933-024-02402-z
WOS ID 001296616300004
Scopus ID 85202000835
PubMed ID 39175055
Erfassungsdatum 2024-10-02
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