Association of cardiac troponin I with prothrombotic alterations in atrial fibrillation

Matusik, Paweł T.; Prior, Shannon M.; Butenas, Saulius; Małecka, Barbara; Lelakowski, Jacek; Undas, Anetta

doi:10.5603/kp.2018.0134

Cited by 16 publications

(11 citation statements)

References 12 publications

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“…We excluded individuals with myocardial infarction or venous thromboembolism within the previous 3 months, kidney failure requiring dialysis or creatinine clearance < 15 mL/min, liver cirrhosis, known cancer and acute infection. Comorbidities and clinical scores were assessed as described [5,6]. The study protocol was approved by bioethical committee and all patients gave informed consent to participate in the study.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, in AF N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin (cTn-hs) have been shown to be strong and independent predictors of thromboembolism and when combined with clinical data, improve stroke risk assessment [3,4]. Moreover, the two biomarkers have been reported to be associated with a prothrombotic state in AF [5,6]. In addition, in patients with AF on anticoagulation, NT-proBNP was not an independent predictor of major bleeding [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Association of NT-proBNP and GDF-15 with markers of a prothrombotic state in patients with atrial fibrillation off anticoagulation

et al. 2019

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We investigated whether growth differentiation factor-15 (GDF-15), also known as macrophage inhibitory cytokine-1 (MIC-1), levels are associated with a prothrombotic state in atrial fibrillation (AF) as compared to N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (cTnI-hs). In 103 patients with AF assessed off anticoagulation (age: 71.0 [65.0-76.0] years; CHA 2 DS 2 -VASc score: 4.6 ± 1.7), we measured endogenous thrombin potential (ETP), plasma fibrin clot permeability (K s , a measure of clot density) and clot lysis time (CLT) and other hemostatic parameters, along with GDF-15, NT-proBNP, and cTnI-hs. GDF-15 positively correlated with ETP and CLT (r = 0.25, P = 0.01 and R = 0.56, P < 0.0001, respectively) but not with K s , von Willebrand factor, thrombin-activatable fibrinolysis inhibitor, plasminogen, antiplasmin or tissue-type plasminogen activator antigen. NT-proBNP showed a stronger association with ETP (r = 0.60, P < 0.0001) and a similar correlation with CLT (R = 0.53, P < 0.0001), while cTnI-hs correlated solely with CLT (R = 0.25, P = 0.01). After adjustment for clinical and laboratory parameters, GDF-15 was a better independent predictor of CLT (unstandardized coefficient B 0.009; 95% confidence interval [CI] 0.006-0.012) than NT-proBNP (B 0.007; 95% CI 0.004-0.010, R (2) = 0.51; P < 0.0001); while among the three biomarkers, only NT-proBNP was an independent predictor of ETP. Elevated GDF-15 and NT-proBNP independently predict impaired fibrin clot lysability, while NT-proBNP is a key predictor of heightened thrombin formation in AF. Our findings suggest that a predictive value of NT-proBNP and GDF-15 in AF could be in part attributed to their association with prothrombotic blood alterations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of NT-proBNP and GDF-15 with markers of a prothrombotic state in patients with atrial fibrillation off anticoagulation

et al. 2019

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“…Stage 3 and 4 CKD were defined as eGFR 30-59 mL/min/1.73 m 2 and 15-29 mL/min/1.73 m 2 , respectively. We calculated the CHA 2 DS 2 -VASc score [21], the R-CHA 2 DS 2 -VASc and R 2 -CHA 2 DS 2 -VASc scores by addition of one or two points, respectively, for the presence of eGFR < 60 mL/min/1.73 m 2 [4,22]. Elevated C-reactive protein (CRP) was defined as >3 mg/L.…”

Section: Patientsmentioning

confidence: 99%

Chronic Kidney Disease and Its Impact on a Prothrombotic State in Patients with Atrial Fibrillation

Matusik

Heleniak

Papuga-Szela

et al. 2020

JCM

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It is unclear whether chronic kidney disease (CKD) increases thromboembolism in atrial fibrillation (AF). We conducted a retrospective cross-sectional analysis of 502 non-anticoagulated AF patients (median age, 66 (60–73) years, median CHA2DS2-VASc score, 3.0 (2.0–4.0)) with an estimated glomerular filtration rate (eGFR) ≥ 15 mL/min/1.73 m2. Endogenous thrombin potential (ETP), clot permeability (Ks), and clot lysis time (CLT), among others, were determined. Patients with stage 4 CKD (n = 87; 17.3%) had higher ETP and prolonged CLT compared with those with stage 3 CKD. In patients with stages 3 to 4 CKD (n = 180; 35.9%) N-terminal pro-B-type natriuretic peptide predicted low Ks (the lowest quartile, odds ratio [OR] per 100 pg/mL: 1.03, 95% confidence interval [CI]: 1.01–1.06) and prolonged CLT (the top quartile, OR per 100 pg/mL: 1.05, 95% CI: 1.02–1.08), but not high ETP. In the whole cohort, after adjustment for CHA2DS2-VASc score, stage 4 CKD, but not stage 3 CKD, predicted high ETP (OR: 9.06; 95% CI: 4.44−18.46) and prolonged CLT (OR: 3.58; 95% CI: 1.76–7.28), but not low Ks. compared to the reference eGFR category. This study is the first to demonstrate the prothrombotic and antifibrinolytic alterations in AF patients with stage 4 CKD, but not stage 3 CKD irrespective of clinical stroke risk factors.

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“…Cardiovascular risk stratification is important and could be improved by the use of biomarkers or data from Holter electrocardiogram recordings [37][38][39]. Some studies have demonstrated that the presence of LGE predicts poor clinical outcomes such as hospitalization due to HF, fatal ventricular arrhythmias, and SCD, in patients with either an ischemic or nonischemic etiology of HF [8,26,[40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction

et al. 2021

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Background: Late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) may reveal myocardial fibrosis which is associated with adverse clinical outcomes in patients undergoing implantable cardioverter-defibrillator (ICD) placement. At the same time, transmural LGE in the posterolateral wall is related to nonresponse to conventional cardiac resynchronization therapy (CRT). Herein, the aim was to assess the presence and determinants of LGE in CMR in heart failure (HF) with reduced ejection fraction. Methods: 67 patients were included (17.9% female, aged 45 [29-60] years), who underwentLGE-CMR and had left ventricular ejection fraction (LVEF) as determined by echocardiography. Results:In HF patients with LVEF ≤ 35% (n = 29), ischemic and non-ischemic patterns ofLGE were observed in 51.7% and 34.5% of patients, respectively. In controls (n = 38), these patterns were noted in 23.7% and 42.1% of patients, respectively. HF patients with LVEF ≤ 35% and transmural LGE in the posterolateral wall (31.0%) were characterized by older age, coronary artery disease (CAD) and previous myocardial infarction (MI) (61 ± 6 vs. 49 ± 16 years, p = 0.008, 100% vs. 40%, p = 0.003 and 78% vs. 25%, p = 0.014, respectively). In patients with LVEF ≤ 35%, LGE of any type, diagnosed in 86.2% of patients, was associated with CAD (68% vs. 0%, p = 0.02), while only trends were observed for its association with older age and previous MI (p = 0.08 and p = 0.12, respectively). Conclusions: Among HF patients with LVEF ≤ 35%, clinical factors including older age, CAD, and previous MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures. Key words: heart failure, late gadolinium enhancement, ischemic, cardiac magnetic resonance, transmural late gadolinium enhancement, cardiac resynchronization therapy, implantable cardioverter-defibrillator CONCLUSIONS Among HF patients with LVEF of 35% or less, clinical factors, including older age, CAD, and previous MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures.

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Association of cardiac troponin I with prothrombotic alterations in atrial fibrillation

Cited by 16 publications

References 12 publications

Association of NT-proBNP and GDF-15 with markers of a prothrombotic state in patients with atrial fibrillation off anticoagulation

Association of NT-proBNP and GDF-15 with markers of a prothrombotic state in patients with atrial fibrillation off anticoagulation

Chronic Kidney Disease and Its Impact on a Prothrombotic State in Patients with Atrial Fibrillation

Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction

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