Significant association of anti-platelet factor 4/heparin antibody with cardiovascular disease in hemodialysis patients: a longitudinal 7-year study.

Abstract

BACKGROUND:

Hemodialysis patients have a high incidence of anti-platelet factor 4/heparin antibody (PF4-H Ab) and are at a high risk of cardiovascular disease. This study determines the association between PF4-H Ab and cardiovascular events including coronary artery disease (CAD), ischemic stroke (IS), and native arteriovenous fistula thrombosis (AVFT), in a longitudinal 7-year follow-up.

PATIENTS AND METHODS:

84 hemodialysis patients were enrolled. Data collection included chart reviews and assessments of laboratory records. PF4-H Ab was evaluated by ELISA and a titer ≥ 0.4 was defined to have PF4-H Ab.

RESULTS:

30 patients were PF4-H Ab positive, 30 patients had CAD, 29 patients had IS, and 43 patients had AVFT. In Cox proportional hazard regression analysis, PF4-H Ab (HR 2.72, p = 0.01) was a significant risk factor for CAD. Age (HR 1.06, p = 0.003), PF4-H Ab (HR 4.53, p < 0.001), 7-year averaged serum phosphate levels (HR 0.53, p = 0.012), and 7-year averaged blood platelet count (HR 1.01, p = 0.029) were risk factors for IS. Age (HR 1.03, p = 0.047), PF4-H Ab (HR 3.57, p < 0.001), and 7-year averaged serum triglyceride levels (HR 1.01, p = 0.005) were risk factors for AVFT. In PF4-H Ab-positive groups, thrombocytopenia was not associated with CAD, IS, and AVFT by Fisher's test analysis.

CONCLUSION:

This study reveals that PF4-H Ab is a risk factor for developing CAD, IS, and AVFT among hemodialysis patients.

• Authors: Chi-Chu Liu, Li-Ping Chou, Tsang-Shan Chen, Chien-An Chen, Yueh-Feng Tsai
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 50 Issue 12 Pg. 2289-2297 (Dec 2018) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 30324576 (Publication Type: Journal Article, Observational Study)

Chemical References

• Antibodies
• Phosphates
• Triglycerides
• Platelet Factor 4

Topics

• Age Factors
• Aged
• Antibodies (blood)
• Arteriovenous Shunt, Surgical (adverse effects)
• Brain Ischemia (complications, epidemiology)
• Cardiovascular Diseases (epidemiology)
• Coronary Artery Disease (epidemiology)
• Female
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Phosphates (blood)
• Platelet Count
• Platelet Factor 4 (immunology)
• Renal Dialysis
• Renal Insufficiency, Chronic (blood, therapy)
• Retrospective Studies
• Risk Factors
• Stroke (epidemiology, etiology)
• Thrombocytopenia (epidemiology)
• Thrombosis (epidemiology, etiology)
• Triglycerides (blood)