Performed at the College of Veterinary Medicine, Cornell University. Presented as an abstract (< 250 words) at the Annual Meeting of the American College of Veterinary Pathologists, Savannah, GA, 2007.
Hypercoagulability in Cats with Cardiomyopathy
Version of Record online: 10 JUL 2008
Copyright © 2008 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 22, Issue 3, pages 546–552, May–June 2008
How to Cite
Stokol, T., Brooks, M., Rush, J.E., Rishniw, M., Erb, H., Rozanski, E., Kraus, M.S. and Gelzer, A.L. (2008), Hypercoagulability in Cats with Cardiomyopathy. Journal of Veterinary Internal Medicine, 22: 546–552. doi: 10.1111/j.1939-1676.2008.0098.x
- Issue online: 10 JUL 2008
- Version of Record online: 10 JUL 2008
- Submitted October 22, 2007; Revised December 28, 2007; Accepted February 11, 2008.
Vol. 23, Issue 1, 224, Version of Record online: 6 JAN 2009
- Aortic thromboembolism;
- Endothelial injury;
- Spontaneous echocardiographic contrast;
- Thrombin-antithrombin complexes
Background: Arterial thromboembolism (ATE) is a common complication of feline cardiomyopathy; however, the pathogenesis of ATE is unknown.
Hypothesis: Systemic activation of the coagulation cascade (hypercoagulability) and endothelial injury promote ATE in cardiomyopathic cats.
Animals: Healthy cats (n = 30) and 3 groups of cardiomyopathic cats: Group (1) left atrial enlargement only (LAE [n = 11]), ie, left atrial to aortic ratio >1.4; Group (2) LAE with spontaneous echocardiographic contrast, atrial thrombi or both (SEC-T [n = 16]); and Group (3) acute ATE with LAE (n = 16).
Methods: Hypercoagulability was defined by 2 or more laboratory abnormalities reflecting coagulation factor excess (high fibrinogen concentration or Factor VIII coagulant activity), inhibitor deficiency (low antithrombin activity), or thrombin generation (high thrombin-antithrombin complex [TAT] and d-dimer concentrations). High von Willebrand factor antigen concentration (vWF : Ag) was considered a marker of endothelial injury. Data were analyzed using nonparametric statistics.
Results: The 3 groups of cats with cardiac disease had higher median fibrinogen concentrations than did the healthy cats. Criteria of hypercoagulability were found exclusively in cats with SEC-T (50%) and ATE (56%). Hypercoagulability was not associated with left atrial size or congestive heart failure (CHF). ATE cats had significantly higher median vWF : Ag concentration than did the other groups.
Conclusinos and Clinical Importance: Systemic hypercoagulability is evident in many cardiomyopathic cats, often without concurrent CHF or overt ATE. Hypercoagulabilty may represent a risk factor for ATE. High vWF : Ag in ATE cats was attributed to downstream endothelial injury from the occlusive thrombus.