Coagulation Biomarkers and Clinical Outcomes in Elderly Patients With Nonvalvular Atrial Fibrillation

Koretsune, Yukihiro; Yamashita, Takeshi; Akao, Masaharu; Atarashi, Hirotsugu; Ikeda, Takanori; Okumura, Ken; Shimizu, Wataru; Suzuki, Shinya; Tsutsui, Hiroyuki; Toyoda, Kazunori; Hirayama, Atsushi; Yasaka, Masahiro; Yamaguchi, Takenori; Teramukai, Satoshi; Kimura, Tetsuya; Morishima, Yoshiyuki; Takita, Atsushi; Inoue, Hiroshi

doi:10.1016/j.jacasi.2023.06.004

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…A recent prospective, multicenter observational study involving a 2-year follow-up (ANAFIE Registry) reported a relationship between coagulation biomarkers (D-dimer and thrombin generation) and clinical outcomes beyond classical thromboembolic events in elderly patients with AF [68]. It has been suggested that high coagulation pathway activity may contribute to these clinical events [68]. This highlights that thrombo-inflammation can explain the residual cardiovascular risk observed in patients with AF and its need to be therapeutically addressed.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Biomarkers of Thrombo-Inflammation in Patients with First-Diagnosed Atrial Fibrillation

Friebel,

Wegner,

Blöbaum

et al. 2024

IJMS

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Patients with first-diagnosed atrial fibrillation (FDAF) exhibit major adverse cardiovascular events (MACEs) during follow-up. Preclinical models have demonstrated that thrombo-inflammation mediates adverse cardiac remodeling and atherothrombotic events. We have hypothesized that thrombin activity (FIIa) links coagulation with inflammation and cardiac fibrosis/dysfunction. Surrogate markers of the thrombo-inflammatory response in plasma have not been characterized in FDAF. In this prospective longitudinal study, patients presenting with FDAF (n = 80), and 20 matched controls, were included. FIIa generation and activity in plasma were increased in the patients with early AF compared to the patients with chronic cardiovascular disease without AF (controls; p < 0.0001). This increase was accompanied by elevated biomarkers (ELISA) of platelet and endothelial activation in plasma. Pro-inflammatory peripheral immune cells (TNF-α+ or IL-6+) that expressed FIIa-activated protease-activated receptor 1 (PAR1) (flow cytometry) circulated more frequently in patients with FDAF compared to the controls (p < 0.0001). FIIa activity correlated with cardiac fibrosis (collagen turnover) and cardiac dysfunction (NT-pro ANP/NT-pro BNP) surrogate markers. FIIa activity in plasma was higher in patients with FDAF who experienced MACE. Signaling via FIIa might be a presumed link between the coagulation system (tissue factor-FXa/FIIa-PAR1 axis), inflammation, and pro-fibrotic pathways (thrombo-inflammation) in FDAF.

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Section: Discussionmentioning

confidence: 99%

Characterization of Biomarkers of Thrombo-Inflammation in Patients with First-Diagnosed Atrial Fibrillation

Friebel,

Wegner,

Blöbaum

et al. 2024

IJMS

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Association Between Atrial Fibrillation Symptoms and Clinical Outcomes: A Prospective Multicenter Registry Study

Lee,

Park,

Park

et al. 2024

The American Journal of Cardiology

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Asymmetric dimethylarginine correlates with indicators of prethrombotic state in patients with nonvalvular atrial fibrillation

Du,

Jiang,

et al. 2024

Pacing Clinical Electrophis

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ObjectiveThe mechanism of asymmetric dimethylarginine (ADMA) in thrombosis in patients with nonvalvular atrial fibrillation (NVAF) is still unclear. Our aim was to investigate the relationship between ADMA and indicators of prethrombotic state in NVAF patients and to analyze the predictive role of ADMA in NVAF thrombosis.MethodsA total of 192 NVAF patients were continuously selected from January 2023 to October 2023. Plasma ADMA levels were measured by high‐performance liquid chromatography. P‐selectin (P‐sel), von Willebrand factor (vWF), D‐dimer (D‐D), and plasminogen activator inhibitor‐1 (PAI‐1) levels were measured by enzyme‐linked immunosorbent assay (ELISA). Nitric oxide (NO) levels were measured by the nitrate reductase assay for plasma nitrite/nitrate, then the Griess method (Shanghai Hailian Biotechnology Co., Shanghai, China) was used to calculate plasma NO levels.ResultsIn our study, ADMA levels were significantly elevated and positively correlated with P‐sel, vWF, D‐D, and PAI‐1, whereas NO levels were significantly negatively correlated with these prethrombotic factors in NVAF. Furthermore, multifactorial logistic regression analysis showed that ADMA and LA diameter were independent predictors of high thrombosis risk (CHA2DS2‐VASc ≥2 score) in patients with NVAF.ConclusionsOur findings suggested that ADMA correlated with the prethrombotic state in NVAF and that reduction of ADMA levels in NVAF patients may be a novel therapeutic strategy for thrombosis risk reduction.

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Coagulation Biomarkers and Clinical Outcomes in Elderly Patients With Nonvalvular Atrial Fibrillation

Cited by 4 publications

References 30 publications

Characterization of Biomarkers of Thrombo-Inflammation in Patients with First-Diagnosed Atrial Fibrillation

Characterization of Biomarkers of Thrombo-Inflammation in Patients with First-Diagnosed Atrial Fibrillation

Association Between Atrial Fibrillation Symptoms and Clinical Outcomes: A Prospective Multicenter Registry Study

Asymmetric dimethylarginine correlates with indicators of prethrombotic state in patients with nonvalvular atrial fibrillation

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