Mariya Negreva1, Krasimira Prodanova2, Ana Zarkova3. 1. Associate professor at Department of Cardiology, Medical University of Varna, First clinic of cardiology, Varna University Hospital "St. Marina", Varna, Bulgaria. 2. Professor at Faculty of applied mathematics and informatics, Technical University of Sofia, Sofia, Bulgaria. 3. Doctor at National Specialized Hospital for Active Treatment of Hematologic Diseases, Sofia, Bulgaria.
Abstract
OBJECTIVE: It remains unclear whether atrial fibrillation (AF) alone determines systemic changes in hemocoagulation. Our aim was to examine the prothrombin fragment F1+2 and fibrinopeptide A (FPA) as early markers of coagulation activity still in the first twenty-four hours of paroxysmal AF (PAF) and to correlate them with the arrhythmia onset. METHODS: 51 non-anticoagulated patients (26 men, 25 women, aged 59.84±1.6 years) and 52 controls (26 men, 26 women, aged 59.50±1.46 years) were sequentially selected. F1+2 and FPA plasma levels were measured by enzyme-linked immunoassays. RESULTS: F1+2 was significantly higher in patients (292.61pmol/L±14.03pmol/L vs 183.40pmol/L±8.38pmol/L; p<0.001). FPA was also substantially higher (4.47ng/mL±0.25 ng/mL vs 3.09ng/mL±0.15ng/mL, p<0.001). Among the potential predictors for these deviations: age, gender, BMI, PAF duration and CHA2DS2-VASc score, it was established that higher F1+2 and FPA plasma levels were independently associated only with PAF duration (p<0.05). Moreover, longer episodes were associated with higher values of F1+2 (Adjusted R2 = 0.68) and FPA (Adjusted R2 = 0.70). CONCLUSIONS: Increased coagulation activity was present still in the first twenty-four hours of PAF clinical presentation. The disease itself was associated with increasing hypercoagulability over time, suggesting its importance as an independent risk factor for thromboembolic events.
OBJECTIVE: It remains unclear whether atrial fibrillation (AF) alone determines systemic changes in hemocoagulation. Our aim was to examine the prothrombin fragment F1+2 and fibrinopeptide A (FPA) as early markers of coagulation activity still in the first twenty-four hours of paroxysmal AF (PAF) and to correlate them with the arrhythmia onset. METHODS: 51 non-anticoagulated patients (26 men, 25 women, aged 59.84±1.6 years) and 52 controls (26 men, 26 women, aged 59.50±1.46 years) were sequentially selected. F1+2 and FPA plasma levels were measured by enzyme-linked immunoassays. RESULTS: F1+2 was significantly higher in patients (292.61pmol/L±14.03pmol/L vs 183.40pmol/L±8.38pmol/L; p<0.001). FPA was also substantially higher (4.47ng/mL±0.25 ng/mL vs 3.09ng/mL±0.15ng/mL, p<0.001). Among the potential predictors for these deviations: age, gender, BMI, PAF duration and CHA2DS2-VASc score, it was established that higher F1+2 and FPA plasma levels were independently associated only with PAF duration (p<0.05). Moreover, longer episodes were associated with higher values of F1+2 (Adjusted R2 = 0.68) and FPA (Adjusted R2 = 0.70). CONCLUSIONS: Increased coagulation activity was present still in the first twenty-four hours of PAF clinical presentation. The disease itself was associated with increasing hypercoagulability over time, suggesting its importance as an independent risk factor for thromboembolic events.
Authors: Alan S Go; Kristi Reynolds; Jingrong Yang; Nigel Gupta; Judith Lenane; Sue Hee Sung; Teresa N Harrison; Taylor I Liu; Matthew D Solomon Journal: JAMA Cardiol Date: 2018-07-01 Impact factor: 14.676
Authors: T van der Poll; H R Büller; H ten Cate; C H Wortel; K A Bauer; S J van Deventer; C E Hack; H P Sauerwein; R D Rosenberg; J W ten Cate Journal: N Engl J Med Date: 1990-06-07 Impact factor: 91.245
Authors: Taya V Glotzer; Emile G Daoud; D George Wyse; Daniel E Singer; Michael D Ezekowitz; Christopher Hilker; Clayton Miller; Dongfeng Qi; Paul D Ziegler Journal: Circ Arrhythm Electrophysiol Date: 2009-08-04
Authors: Isabelle C Van Gelder; Jeff S Healey; Harry J G M Crijns; Jia Wang; Stefan H Hohnloser; Michael R Gold; Alessandro Capucci; Chu-Pak Lau; Carlos A Morillo; Anne H Hobbelt; Michiel Rienstra; Stuart J Connolly Journal: Eur Heart J Date: 2017-05-01 Impact factor: 29.983