Changes in the levels of factor X (FXA) and factor XII (FXIIA) in patients after permanent pacemaker implantation

Introduction: There are considerable evidences for the activation of coagulation after implantation of medical devices. In addition, the categorical connection between PPM implantation and the development in time of CTEPH (chronic thromboembolic pulmonary hypertension) is proven.

Objectives: To examine the levels of FXa and FXIIa during dynamic in patients after PPM implantation.

Materials and methods: We examined the levels of FXa and FXIIa at the baseline, at 6 weeks, at 12 weeks and at 24 weeks after implantation of dual chamber PPM in 45 patients (25 men and 20 women – median age 72.18 ±9.08yrs.) and in 46 controls (22 women and 24 men – median age 71,96 ±8.75yrs.), corresponding in gender, age and BMI. The method of research was enzyme-linked immunosorbent assay.

Results: The values of FXa and FXIIa at the baseline were not different in patients and controls 92.88 pg/ml vs 98,87 pg/ml (p>0.05) and 95.41 pg/ml vs 100.31 pg/ml (p>0.05). At the 6 and 12 weeks follow up checks, the values of FXa and FXIIa increased significantly compared to those in controls р<0.001 (tabl.1). At 24 weeks, the absolute values were still higher than those in controls, as for FXa the difference did not reach significant meaning (p>0.05) (tabl.1) and the values of FXIIa remained at significantly higher level compared to the controls (p<0.05) (tabl.1).

Conclusion: Due to permanent maintenance of elevated levels of FXa and FXIIa, we believe it can be accepted that the implantation of PPM leads to a lasting procoagulant state.