Linking factor XIII activity to all-cause mortality after myocardial infarction: the overlooked role of serum albumin

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-09-11 DOI:10.1016/j.ijcha.2025.101796

Jan Traub , Makram Abu Hussein , Dominik Schmitt , Anna Frey

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引用次数: 0

Abstract

Background

Acute myocardial infarction (MI) remains a major cause of morbidity and mortality despite therapeutic advances. Factor XIII (FXIII), a fibrin-stabilizing enzyme with roles in coagulation, inflammation, and tissue repair, has emerged as a potential biomarker in MI. While low FXIII activity has been linked to adverse outcomes, the underlying determinants and its independent prognostic value remain unclear.

Methods

In this retrospective study, FXIII activity was measured in 926 MI patients treated at University Hospital Würzburg between 2018 and 2023. Blood samples were collected within 24 h of cardiac catheterization. FXIII activity was assessed photometrically, and patients were followed for all-cause mortality. Multivariable regression and Cox models were used to identify predictors of FXIII activity and mortality.

Results

Median FXIII activity was 110 %. Lower FXIII activity was associated with older age, female sex, lower albumin, higher CRP, and reduced kidney function. While crude mortality at 30 days and 1 year was significantly higher in patients with FXIII ≤ 110 %, FXIII activity was not an independent predictor of mortality after adjustment. Key predictors included albumin (HR = 0.221, p < 0.001), age (HR = 1.048, p < 0.001), eGFR (HR = 0.988, p = 0.001), and ASAT (HR = 1.001, p = 0.002).

Conclusions

Although lower FXIII activity is associated with higher mortality post-MI, this effect is largely mediated by albumin levels. Albumin appears to be a central determinant of both FXIII activity and prognosis, highlighting its potential role as a key marker in risk stratification. Further studies are warranted to explore therapeutic implications of hypoalbuminemia in MI.

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将因子XIII活性与心肌梗死后的全因死亡率联系起来：血清白蛋白被忽视的作用

背景：尽管治疗进展，急性心肌梗死（MI）仍然是发病率和死亡率的主要原因。因子XIII （FXIII）是一种纤维蛋白稳定酶，在凝血、炎症和组织修复中发挥作用，已成为心肌梗死的潜在生物标志物。虽然低FXIII活性与不良结局有关，但其潜在的决定因素及其独立的预后价值尚不清楚。方法在这项回顾性研究中，测量了2018年至2023年在德国 rzburg大学医院治疗的926例心肌梗死患者的FXIII活性。心导管置管后24小时内采集血样。用光度法评估FXIII活性，并随访患者的全因死亡率。采用多变量回归和Cox模型确定FXIII活性和死亡率的预测因子。结果FXIII活性中位数为110%。较低的FXIII活性与年龄较大、女性、较低的白蛋白、较高的CRP和肾功能降低有关。虽然FXIII≤110%的患者30天和1年的粗死亡率明显更高，但调整后FXIII活性并不是死亡率的独立预测因子。主要预测因子包括白蛋白(HR = 0.221, p & lt; 0.001)、年龄(HR = 1.048, p & lt; 0.001)、表皮生长因子受体(HR = 0.988, p = 0.001),和ASAT (HR = 1.001, p = 0.002)。结论：虽然FXIII活性降低与心肌梗死后死亡率升高有关，但这种影响主要是由白蛋白水平介导的。白蛋白似乎是FXIII活性和预后的中心决定因素，突出了其作为风险分层关键标志物的潜在作用。有必要进一步研究低白蛋白血症对心肌梗死的治疗意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.