Gender Is a Significant Factor Affecting Blood Coagulation Systems

Abstract

The risk of cardiogenic cerebral infarction is quantified by the CHA2DS2-VASc score in patients with atrial fibrillation, with female gender shown to be one of the risk factors. However, the relationships between gender and blood coagulation markers have not been investigated. Thus, the aim of the present study was to investigate relationships between gender and the coagulation and fibrinolysis systems. In the present study, 1025 patients(517 females[F group], 508 males[M group])who visited the outpatient clinic and had markers of the fibrinolytic and coagulation systems measured at the Division of Cardiology of Showa University Hospital from June 2011 to June 2014 were evaluated retrospectively. Thrombomodulin(TM), prothrombin fragment 1+2(PTF 1+2), thrombin-antithrombin complex(TAT), plasmin-α₂-plasmin inhibitor complex(PIC), and D-dimer levels were analyzed. Furthermore, patients without diabetes mellitus and vascular disease were divided into two groups according to age: a younger(Y)group(<75 years)and an elderly(E)group(≥75 years). In the Y group, TM levels were significantly lower in the F than M group(P<0.0001), but in the E group there was no significant difference in TM levels between these two groups. PTF 1+2 levels were significantly higher in the F group for each age group(Y group, P=0.0426; E group, P=0.0214). In the Y group, PIC levels were significantly higher in the F than M group(P=0.0015), but there was no difference in PIC levels between the F and M groups in the E group. Thus, in the F group, vascular endothelial dysfunction progressed in the E group. These observations suggest that the coagulation system is relatively accelerated, without any acceleration in the fibrinolytic system, in the F group with aging. The present study has shown that, in outpatients of a cardiovascular department, gender is a significant factor affecting blood coagulation systems.