Effects of Aging on the Coagulation Fibrinolytic System in Outpatients of the Cardiovascular Department

Ochi, Akinori; Adachi, Taro; Inokuchi, Kaoru; Ogawa, Kōichi; Nakamura, Yuya; Chiba, Yuta; Kawasaki, Shiro; Onishi, Yuki; Onuma, Yoshimasa; Munetsugu, Yumi; Ito, Hiroyuki; Onuki, Tatsuya; Minoura, Yoshino; Watanabe, Norikazu; Kawamura, Mitsuru; Asano, Taku; Kobayashi, Youichi

doi:10.1253/circj.cj-16-0530

Cited by 17 publications

(10 citation statements)

References 32 publications

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“…58 Besides homocysteine (or perhaps in part because of homocysteine), levels of several markers of coagulation and impaired fibrinolysis are higher in elderly patients. Ochi et al 59 found higher levels of D-dimer, prothrombin-fragment1 þ 2 (F1 þ 2), plasmin-α2 plasmin inhibitor complex, and thrombomodulin among medical outpatients age ! 75.…”

Section: Undiagnosed Metabolic B12 Deficiencymentioning

confidence: 99%

Nutrition in Stroke Prevention

Spence

2017

Semin Neurol

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Nutrition is far more important to the prevention of stroke than most physicians realize. Key issues include a Mediterranean diet, the interaction of the intestinal microbiome, impaired renal function and diet, missed metabolic B12 deficiency, and the lowering of homocysteine with B vitamins to prevent stroke. The Cretan Mediterranean diet is high in olive oil, whole grains, fruits, vegetables, and legumes, and is close to a vegetarian diet. Compared with a low-fat diet, it reduced stroke by over 40%, and is clearly the best diet for diabetes. Metabolic B12 deficiency is very common (∼ 30% of stroke patients age > 70 years) and frequently missed because it is not excluded by a total serum B12 level in the reference range. B vitamins to lower homocysteine do prevent stroke, but their benefit was obscured in early studies because of harm from cyanide in cyanocobalamin among participants with renal impairment. Methylcobalamin should be used instead of cyanocobalamin.

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Section: Undiagnosed Metabolic B12 Deficiencymentioning

confidence: 99%

Nutrition in Stroke Prevention

Spence

2017

Semin Neurol

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“…Based on these observations, it is conceivable to say that the risk for Figure 1. Schematic of the main findings by Ochi et al 7 Levels of blood markers of coagulation and fibrinolysis increase in association with increasing age, without differences between males and females in any age group.…”

Section: Article P 2133mentioning

confidence: 90%

Aging　– The Great Impact on Coagulation State –

Takahashi

2016

Circ J

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2092TAKAHASHI N Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp those aged 65-74 years is not so high, but for those aged ≥75 years it is remarkably high. In this issue of the Journal, Ochi et al 7 report on their study in which they measured plasma levels of D-dimer, prothrombin-fragment1+2 (F1+2), plasmin-α2 plasmin inhibitor complex (PIC), and thrombomodulin (TM) in "real-world" cardiology outpatients. D-dimer is a byproduct of the degradation of fibrin, reflecting thrombin and fibrin turnover, and is a surrogate marker for a hypercoagulable state. F1+2, which arises from in vivo cleavage of prothrombin by factor Xa, is considered to be useful for diagnosis of thrombosis. PIC is a fibrinolytic marker that directly reflects the generation of plasmin in vivo. Soluble TM is considered to be a marker of plasma endothelial damage or dysfunction marker. Ochi et al 7 demonstrate a significant correlation between aging and the levels of F1+2, D-dimer, and PIC. In contrast, there were no sex-associated differences in these markers of coagulation and fibrinolysis. When examining the determinants of high F1+2 isk stratification for stroke and thromboembolism in patients with non-valvular atrial fibrillation (NVAF) is very important to identify those patients requiring oral anticoagulation therapy. The simplest risk assessment scheme is the CHADS2 score. The CHA2DS2-VASc score is inclusive of the most common stroke risk factors in everyday clinical practice. The characteristics of the CHA2DS2-VASc score, compared with the CHADS2 score, is that either age 65-74 or female sex is counted as 1 point risk. Age ≥75 is doubly counted as 2 points. In fact, the ESC guideline proposed that previous stroke, transient ischemic attack (TIA) or systemic embolism, and age ≥75 should be regarded as "major" risk factors, while the other 6 are "clinically relevant non-major" risk factors. 2 Here, I would like to discuss the impact of aging and sex category in Japanese NVAF patients. Article p 2133In the J-RHYTHM Registry, consecutive patients with AF were recruited from the outpatient clinic of each participating institution from January 2009 to July 2009. 3 A total of 7,937 patients with AF (mean age, 70 years) were enrolled. Subanalysis of the J-RHYTHM Registry has demonstrated that female sex is not a risk factor for thromboembolic events in those who were treated mostly with warfarin. 4 Subsequently, the validity of risk scoring systems excluding female sex from CHA2DS2-VASc was reported. 5 What about aging? Suzuki et al 6 performed a pooled analysis of 3,588 patients from the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry to determine the incidence rate of ischemic stroke in Japanese NVAF patients without anticoagulation therapy. Their analysis revealed that the incidence of ischemic stroke increased with age from 6.9 per 1,000 person-years in patients aged <65 years to 9.8 per 1,000 person-years in those aged 65-74 years and 24.5 per 1,000 person-years in those aged ≥75...

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“…In the circulatory system, represented by blood and spleen, down-regulation of coagulation factors was observed in breeders. Because coagulation factors are known to be up-regulated during aging in humans mice, rats, and even fish, this can be interpreted as a sign of a more juvenile breeders' transcriptome (Ochi et al 2016;Benayoun et al 2019). Furthermore, the activity of coagulation factors is associated with a higher risk of coronary heart disease (Lowe and Rumley 2014).…”

Section: Discussionmentioning

confidence: 99%

Increased longevity due to sexual activity in mole-rats is associated with transcriptional changes in the HPA stress axis

Sahm

Platzer

Koch

et al. 2021

eLife

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Sexual activity and/or reproduction are associated with a doubling of life expectancy in the long-lived rodent genus Fukomys. To investigate the molecular mechanisms underlying this phenomenon, we analyzed 636 RNA-seq samples across 15 tissues. This analysis suggests that changes in the regulation of the hypothalamic-pituitary-adrenal stress axis play a key role regarding the extended life expectancy of reproductive vs. non-reproductive mole-rats. This is substantiated by a corpus of independent evidence. In accordance with previous studies, the up-regulation of the proteasome and so-called "anti-aging molecules", e.g. DHEA, is linked with enhanced lifespan. On the other hand, several of our results are not consistent with knowledge about aging of short-lived model organisms. For example, we found the up-regulation of the IGF1/GH axis and several other anabolic processes to be compatible with a considerable lifespan prolongation. These contradictions question the extent to which findings from short-lived species can be transferred to longer-lived ones.

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Effects of Aging on the Coagulation Fibrinolytic System in Outpatients of the Cardiovascular Department

Cited by 17 publications

References 32 publications

Nutrition in Stroke Prevention

Nutrition in Stroke Prevention

Aging　– The Great Impact on Coagulation State –

Increased longevity due to sexual activity in mole-rats is associated with transcriptional changes in the HPA stress axis

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Effects of Aging on the Coagulation Fibrinolytic System in Outpatients of the Cardiovascular Department

Cited by 17 publications

References 32 publications

Nutrition in Stroke Prevention

Nutrition in Stroke Prevention

Aging – The Great Impact on Coagulation State –

Increased longevity due to sexual activity in mole-rats is associated with transcriptional changes in the HPA stress axis

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Aging　– The Great Impact on Coagulation State –