Early effects of paroxysmal atrial fibrillation on plasma markers of fibrinolysis

Abstract

There are no studies to date on the early changes in the hemostasis profile of patients with paroxysmal atrial fibrillation (PAF).Given the key role of the fibrinolytic system in maintaining blood fluidity, our aim was to examine its activity in patients with clinical manifestation of the disease <24 hours.We studied 51 nonanticoagulated patients with a first episode of the disease (26 men, 25 women; mean age 59.84 ± 1.60 years) and 52 controls (26 men, 26 women; mean age 59.50 ± 1.46 years) who matched the patients in terms of gender, age, comorbidities, and conducted treatment. Using enzyme-linked immunoassays and colorimetric assays we assessed the plasminogen activity, tissue plasminogen activator level (t-PA), plasminogen activator inhibitor 1 activity (PAI-1), α2-antiplasmin activity (α2-AP), D-dimer level, and vitronectin level. Blood samples were collected immediately after hospitalization.Patients were hospitalized between the second and twenty fourth hours (mean 8.14 ± 0.76 hours) after the onset of PAF. Compared to controls, plasminogen (159.40 ± 4.81 vs 100.2 ± 2.88%, P < 0.001) and t-PA levels (11.25 ± 0.35 vs 6.05 ± 0.31 ng/mL, P < 0.001) were significantly higher in the patient group. PAI-1 activity (7.33 ± 0.37 vs 15.15 ± 0.52 AU/mL, P < 0.001) and α2-AP (112.9 ± 2.80 vs 125.60 ± 3.74%, P < 0.05) as well as vitronectin plasma levels (134.7 ± 5.83 vs 287.3 ± 10.44 mcg/mL, P < 0.001) were lower in the PAF group. Conversely, the levels of D-dimer in patients were significantly higher (0.53 ± 0.07 vs 0.33 ± 0.02 ng/mL, P < 0.05).Early changes in the fibrinolytic system occur in PAF, suggesting their close relationship with the manifestation of the disease. There is high plasma fibrinolytic activity, during the very first 24 hours of the disease, which is most likely a pathophysiological response to the intensified procoagulation process.

Diagnostic Values of Some Fibrinolytic Indicators for Rejecting the Presence of Paroxysmal Atrial Fibrillation

“…In our clinical trial of PAF patients, we found significant changes in major indicators of fibrinolysis as early as the first twenty-four hours of the clinical manifestation of the arrhythmia (Table 1) [10].…”

“…The fibrinolytic parameters were examined in peripheral venous blood. The samples were collected, centrifuged and the resulting citrate plasma stored according to the requirements of the tests used, which have been described in detail elsewhere by us [10]. The indicators were determined using colorimetric and enzyme-linked immunosorbent assays [10].…”

Biomarkers of Thrombo-Inflammatory Responses in Pulmonary Embolism Patients With Pre-Existing Versus New-Onset Atrial Fibrillation

“…7 Multiple studies have also noted this biomarker's utility in AF as an indicator of left atrial enlargement, thrombus formation, and cardiac stress. [8][9][10] Overall, while not clinically relevant in AF, the D-dimer test seems to be an indicator of the prothrombotic atmosphere created by AF. Therefore, we included this biomarker in our study to investigate its role in PE patients with comorbid AF.…”

Atrial Fibrillation: The Role of Hypoxia Inducible Factor-1 Regulated Cytokines

“…Negreva et al reported that PAI-1 activity is lower in patients with paroxysmal AF compared with control patients suggesting that there is high plasma fibrinolytic activity even during the first 24 hours of the disease. 52 Gramley et al observed that with increasing duration of AF, PAI-1 expression decreases, which they attributed to increased atrial fibrosis. 53 Years before even hypothesizing of mechanism for AF's relationship with PAI-1, Pretorius et al reported that perioperative PAI-1 levels can be predictive of developing postoperative AF in patients undergoing coronary artery bypass surgery.…”