Early Changes in the Antithrombin and Thrombin-Antithrombin Complex in Patients With Paroxysmal Atrial Fibrillation

Abstract

BackgroundData on coagulation changes in paroxysmal atrial fibrillation (PAF) are scarce. The aim of this study was to examine plasma antithrombin (AT) levels and activity as well as thrombin-antithrombin (TAT) complex levels in the early hours of the clinical manifestation of PAF.MethodsFifty-one patients (26 men and 25 women; mean age 59.84 ± 1.60 years) were consecutively selected with PAF duration < 24 hours, and 52 controls (26 men and 26 women; mean age 59.50 ± 1.46 years) matched the patients in terms of gender, age and comorbidities. Plasma levels and activity of AT and levels of the covalent TAT complex were studied once in each study participant.ResultsAT plasma levels in PAF patients were statistically significantly lower compared to controls (164.69 ± 10.51 vs. 276.21 ± 8.29 μg/mL, P < 0.001). Plasma activity of the anticoagulant was also significantly lower in PAF (71.33±4.87 vs. 110.72±3.09%, P < 0.001). TAT complex concentration in plasma was higher in the patient group (5.32 ± 0.23 vs. 3.20 ± 0.14 μg/L, P < 0.001).ConclusionWe can say that PAF is associated with significantly reduced AT levels and activity and increased levels of TAT complex during the first 24 hours after its manifestation. These changes indicate a reduced activity of AT anticoagulant system, which is a probable prerequisite for the established enhanced coagulation (high TAT complex levels).

Markers of Coagulation and Fibrinolysis Predicting the Outcome of Acute Ischemic Stroke Thrombolysis Treatment: A Review of the Literature

“…Antithrombin is a major inhibitor of thrombin, forming a 1:1 stable complex with it (thrombin-antithrombin complex: TAT). TAT complex is a sensitive marker for the activation of intravascular coagulation, thus useful for the risk assessment and diagnosis of thromboembolic events (53). Levels of TAT has been investigated in the population of the NINDS trial from samples collected at baseline, at 2 h after treatment and after 24 h post-lysis (27).…”

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

“…AF has been associated with elevated levels of D-dimer, 17 , F1+2, 18 and TAT, 19 , 20 suggesting activation of the coagulation pathway. In the DOAC group, higher levels of D-dimer (≥1.0 μg/mL) and TAT (>3 ng/mL) were significantly associated with increased incidences of CV events, CV death, and all-cause death, and higher levels of F1+2 (≥229 pmol/L) were significantly associated with increased incidences of CV events and all-cause death, suggesting that high activity of the coagulation pathway may contribute to these clinical events.…”