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Hypercoagulability in centenarians: the paradox of successful aging
D Mari, PM Mannucci, R Coppola, B Bottasso, KA Bauer and RD Rosenberg
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University of
Milano, Italy.
With advancing age, an increasing number of healthy individuals have
laboratory signs of heightened coagulation enzyme activity. Such
biochemical hypercoagulability might be the basis of either the increased
thrombotic tendency occurring with age or a harmless manifestation of this
process. To see whether these alterations are also present in the very
elderly who had aged successfully, 25 healthy centenarians were studied and
results of coagulation and fibrinolysis measurements were compared with
those obtained in two control groups of healthy adults, 25 ranging in age
from 18 to 50 years and 25 from 51 to 69 years. Older controls had, in
general, slightly higher values of several coagulation and fibrinolysis
measurements than younger controls. Centenarians had striking signs of
heightened coagulation enzyme activity, as assessed directly by measuring
activated factor VII in plasma (P < .01, compared with either control
group) or indirectly by measuring the plasma levels of the activation
peptides of prothrombin, factor IX, factor X, and thrombin-antithrombin
complexes (all P < .001). Heightened coagulation enzyme activity was
accompanied by signs of enhanced formation of fibrin (high fibrinopeptide
A, P < .001) and secondary hyperfibrinolysis (high D-dimer and plasmin-
antiplasmin complex, P < .001). Plasma concentrations of fibrinogen and
factor VIII were higher than in controls, whereas other coagulation factors
were not elevated. In conclusion, this study shows the very elderly do not
escape the state of hypercoagulability associated with aging, but that this
phenomenon is compatible with health and longevity. Hence, high plasma
levels of the coagulation activation markers in older populations do not
necessarily mirror a high risk of arterial or venous thrombosis.
Volume 85,
Issue 11,
pp. 3144-3149,
06/01/1995
Copyright © 1995 by The American Society of Hematology
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