Anti-Platelet Factor 4/Heparin Antibody Plays a Significant Role in Progression of Arterial Stiffness among Hemodialysis Patients.
BACKGROUND
Arterial stiffness is a determinant of cardiovascular disease in end stage renal disease. Hemodialysis patients may develop anti-platelet factor 4/heparin antibody (PF4-H Ab) because of heparin treatment in dialysis. We tested whether PF4-H Ab was associated with progression of arterial stiffness in a 3-year follow-up.


METHODS
We enrolled 74 hemodialysis patients and studied their clinical, biochemical and arterial stiffness measurement with brachial-ankle pulse wave velocity (baPWV) over 3 years. Baseline and changes in baPWV after 3 years (ΔbaPWV) were collected and compared with related clinical and biochemical parameters. PF4-H Ab was evaluated by the enzyme-linked immunosorbent assay and titer ≥ 0.4 was defined to have PF4-H Ab.


RESULTS
We found a positive PF4-H Ab status in 25 of 74 patients. Mean baPWV was 16.1 ± 3.8 (m/s) at baseline and 17.6 ± 4.0 (m/s) after 3 years. Mean ΔbaPWV was 3.4 ± 2.2 (m/s) in the PF4-H Ab positive group, and 0.6 ± 1.2 (m/s) in the PF4-H Ab negative group. Baseline baPWV was only significantly associated with age (β = 0.49, p < 0.01). ΔbaPWV was significantly different between the PF4-H Ab positive and negative groups (p < 0.01). In multivariate regression analysis, only PF4-H Ab was positively associated with ΔbaPWV (β = 0.71, p < 0.01).


CONCLUSIONS
Our study concluded that PF4-H Ab was associated with progression of arterial stiffness in hemodialysis patients.
Department of Cardiology.
Chieh
C
Kuo
Department of Surgery, Tainan Sinlau Hospital; ; Department of Health Care Administration, Chang Jung Christian University.
Chiang-Chin
CC
Tsai
Department of Health Care Administration, Chang Jung Christian University; ; Department of Nephrology, Tainan Sinlau Hospital, Tainan, Taiwan.
Chien-An
CA
Chen
Department of Nephrology, Tainan Sinlau Hospital, Tainan, Taiwan.
Yueh-Feng
YF
Tsai
Department of Cardiology.
Yen-Hsun
YH
Chen
Anti-platelet factor 4-heparin antibody; Arterial stiffness; Brachial-ankle pulse wave velocity; Hemodialysis