Biochemical markers of coagulation activation in mitral stenosis, atrial fibrillation, and cardiomyopathy

Ikeda, Uichi; Yamamoto, Keiji; Shimada, Kazuyuki

doi:10.1002/clc.4960200104

Cited by 34 publications

(17 citation statements)

References 35 publications

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“…In addition, it is associated with an elevated incidence of thrombus in the left atrium (16% vs. 1%) compared to patients without any cardiac arrhythmias [8,53]. As opposed to healthy individuals, patients suffering from rheumatic cardiac disease and AF have been shown to have higher ADP-induced platelet aggregation levels, higher concentrations of beta-thromboglobulins and PF4, signifying platelet activation, and glycocalicin (GPIb fragment) as a marker of damage to the thrombocytic membrane [25].…”

Section: Role Of Platelets In the Pathogenesis Of Thromboembolic Compmentioning

confidence: 99%

Role of Platelets in Thromboembolism in Patients with Atrial Fibrillation

2015

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of patients with AF is diversified. The rate of thromboembolic complications, predisposing factors and destination of embolism are different in valvular atrial fibrillation (VAF) and non-valvular atrial fibrillation (NVAF). Patients with VAF have a higher risk of thromboembolism and a higher prevalence of thrombus location within the body of the left atrium compared to NVAF. VAF is also associated with higher propensity for non-cerebral thromboemboli than in NVAF [5]. There are many as yet unanswered questions surrounding the increased thrombotic tendency in AF. One of the crucial questions is what determines the fact that a thrombus in the left atrium remains in situ in some patients, while in others it breaks off and leads to embolic complications.As in other disorders, the risk of thromboembolic complications in AF is related to the triad of factors proposed by Rudolf Virchow: abnormalities in blood flow, endocardial/vessels wall damage and alterations in blood composition.Symptomatic thromboembolic complications are diagnosed annually on average in 5% of patients with atrial fibrillation (AF); however, the incidence rate of these complications varies over a broad range, from 0.5 to over 20% per year depending on coexisting risk factors [1]. Thromboembolic complications secondary to AF are a major cause of mortality and disability. The most common complication of AF is stroke, accounting for between 80% and over 90% of all embolic events [2]. Embolization of peripheral arteries with thrombotic material originating in the left atrium occurs much less commonly; however, in the group of patients having surgery due to peripheral embolism, 60-95% are diagnosed with AF [3].Thrombus formation in the left atrium can be triggered by a range of factors, both inherited and acquired. It is necessary to take into account factors directly associated with the cardiac rhythm disorder and concomitant diseases [4] AbstractThromboembolic complications of atrial fibrillation (AF) are a major cause of morbidity and mortality but the mechanism of its process remain poorly understood. There are many as yet unanswered questions surrounding the increased thrombotic tendency in AF. One of the crucial questions is what determines the fact that a thrombus remains in the left atrium in situ in some patients, while in others it breaks off and leads to embolic complications. Recent studies indicated an important role of platelets in the left atrial's thrombus formation and suggest that the embolic potential of left atrial thromboses depends on the involvement of platelets in the process of fibrin stabilization rather than aggregation. New methods for investigating platelets function, such as the analysis of transcription activity of RNA coming from platelets contained in thrombi formed in AF, creates an opportunity for studying populations of platelets that are directly involved in homeostatic clot formation. In this paper we present current opinions on the participation of platelets in the pathogenesis of thromboembolism in patients with...

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Section: Role Of Platelets In the Pathogenesis Of Thromboembolic Compmentioning

confidence: 99%

Role of Platelets in Thromboembolism in Patients with Atrial Fibrillation

2015

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“…These investigators concluded that thrombin activity, but not platelet activity, is increased in patients with heart failure and may be linked to left ventricular enlargement and dysfunction [11]. These authors also found that patients with AF but normal systolic function had a pattern similar to that seen in CHF, suggesting mechanic similarities between these conditions [12].…”

Section: Dilated Cardiomyopathy and Chronic Congestive Heart Failurementioning

confidence: 92%

When Oral Anticoagulation Therapy is Needed in Patients With Cardiomyopathies: A Review of Literature

Vizzardi

Bonadei

Magro

et al. 2012

Heart, Lung and Circulation

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“…Its half-life is about 4–5 days. Both indicators have been demonstrated as being useful markers of coagulation activation in several clinical conditions [10, 11, 12, 13, 14, 15, 16]. AF is associated with uncoordinated atrial contractility and results in abnormalities of intracardiac flow and a subsequent prothrombotic state.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Plasma D-Dimer and Fibrinogen in Witnessed Onset of Paroxysmal Atrial Fibrillation

2004

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Background: Although increased D-dimer and fibrinogen have been proved to be related with atrial fibrillation (AF), their evolution in the course of time remains unclear. Methods: To elucidate the evolution of plasma D-dimer and fibrinogen in AF of different duration. 56 patients (group A) of 3,524 patients in whom the onset of AF had been witnessed in a chest pain clinic were enrolled for study. Plasma D-dimer and fibrinogen concentrations were checked within 30 min after the onset of AF and followed up as scheduled. Another 50 patients (group B) with chronic AF underwent the same protocol and served as controls. Results: In group A, the D-dimer levels reached a plateau at the 18th hour (382 ± 52 vs. 840 ± 280 ng/ml, p < 0.001 by ANOVA) and the fibrinogen level increased gradually from 4.1 ± 0.6 g/ml at baseline to 6.1 ± 0.9 g/ml at the 48th hour (p < 0.001). No subjects had evidence of intra-cardiac thrombi by transesophageal echocardiography. There were significant differences in plasma D-dimer and fibrinogen levels between the two groups at each measurement. At the cut- off value of 500 ng/ml, plasma D-dimer had a sensitivity of 100%, a specificity of 93% in defining AF lasting for less than 12 h. The positive and negative predictive values were 52% and 100%, respectively. Plasma D-dimer increased above the normal range prior to the 12th hour after the onset of AF. Conclusion: The observations support its use as a screening tool for identifying patients with short duration AF capable of being safely converted.

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Biochemical markers of coagulation activation in mitral stenosis, atrial fibrillation, and cardiomyopathy

Cited by 34 publications

References 35 publications

Role of Platelets in Thromboembolism in Patients with Atrial Fibrillation

Role of Platelets in Thromboembolism in Patients with Atrial Fibrillation

When Oral Anticoagulation Therapy is Needed in Patients With Cardiomyopathies: A Review of Literature

Evolution of Plasma D-Dimer and Fibrinogen in Witnessed Onset of Paroxysmal Atrial Fibrillation

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