Prognostic value of plasma von Willebrand factor and its cleaving protease ADAMTS13 in patients with atrial fibrillation

Freynhofer, Matthias K.; Gruber, Susanne C.; Bruno, Veronika; Höchtl, Thomas; Farhan, Serdar; Zaller, Vera; Wojta, Johann; Huber, Kurt

doi:10.1016/j.ijcard.2012.09.056

Cited by 22 publications

(29 citation statements)

References 43 publications

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“…21,[29][30][31][32] Patients with AL amyloidosis and heart involvement present mostly with preserved ejection fraction heart failure (HFpEF). 33 Data in patients with nonamyloid-related HFpEF indicate that this entity is characterized by endothelial microvascular inflammation as a potential mediator, which may induce myocardial stiffening and increased collagen deposition, both recognized as underlying mechanisms of cardiac fibrosis and diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Clinical and prognostic significance of serum levels of von Willebrand factor and ADAMTS-13 antigens in AL amyloidosis

Kastritis

Papassotiriou²,

Terpos

et al. 2016

Blood

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Section: Discussionmentioning

confidence: 99%

Clinical and prognostic significance of serum levels of von Willebrand factor and ADAMTS-13 antigens in AL amyloidosis

Kastritis

Papassotiriou²,

Terpos

et al. 2016

Blood

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“…A high ratio of VWF:ADAMTS13 independently predicts major adverse cardiovascular events in patients with AF (hazard ratio 2.17, P=0.007). 143 After cardioversion, the ratio was an independent predictor of recurrent AF (HR 1.88, P=0.03). 144 …”

Section: Atrial Myopathy and Stroke Riskmentioning

confidence: 94%

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

et al. 2015

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Atrial disease or myopathy forms the substrate for atrial fibrillation (AF) and underlies the potential for atrial thrombus formation and subsequent stroke. Current diagnostic approaches in patients with AF focus on identifying clinical predictors with evaluation of left atrial size by echocardiography serving as the sole measure specifically evaluating the atrium. Although the atrial substrate underlying AF is likely developing for years prior to the onset of AF, there is no current evaluation to identify the pre-clinical atrial myopathy. Atrial fibrosis is one component of the atrial substrate that has garnered recent attention based on newer MRI techniques that have been applied to visualize atrial fibrosis in humans with prognostic implications regarding success of treatment. Advanced ECG signal processing, echocardiographic techniques, and MRI imaging of fibrosis and flow provide up-to-date approaches to evaluate the atrial myopathy underlying AF. While thromboembolic risk is currently defined by clinical scores, their predictive value is mediocre. Evaluation of stasis via imaging and biomarkers associated with thrombogenesis may provide enhanced approaches to assess risk for stroke in patients with AF. Better delineation of the atrial myopathy that serves as the substrate for AF and thromboembolic complications might improve treatment outcomes. Furthermore, better delineation of the pathophysiologic mechanisms underlying the development of the atrial substrate for AF, particularly in its earlier stages, could help identify blood and imaging biomarkers that could be useful to assess risk for developing new onset AF and suggest specific pathways that could be targeted for prevention.

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“…However, the association of sP‐selectin with thromboembolic complications in AF patients remains controversial . We previously have investigated the role of endothelial dysfunction by means of von Willebrand factor and ADAMTS13 levels with regard to recurrence of AF as well as with regard to outcomes in the same cohort of AF patients . t‐PA is mainly expressed by vascular endothelial cells and induces clot dissolution by converting plasminogen to plasmin, which then cleaves and inactivates fibrin .…”

Section: Introductionmentioning

confidence: 99%

Endogenous t-PA-antigen is an independent predictor of adverse cardiovascular events and all-cause death in patients with atrial fibrillation

Freynhofer

Draxler

Gruber

et al. 2013

Journal of Thrombosis and Haemostasis

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To cite this article: Freynhofer MK, Draxler DF, Gruber SC, Bruno V, H€ ochtl T, Fellner B, Jakl-Kotauschek G, Wojta J, Pabinger-Fasching I, Huber K, Ay C. Endogenous t-PA-antigen is an independent predictor of adverse cardiovascular events and all-cause death in patients with atrial fibrillation. J Thromb Haemost 2013; 11: 1069-77.Summary. Background: Atrial fibrillation (AF) is associated with raised levels of P-selectin and an apparent prothrombotic state. However, levels of tissue plasminogen activator (t-PA)-antigen are increased also. We investigated whether high levels of endogenous t-PA-antigen or soluble P-Selectin (sP-Selectin), independently of CHADS 2 -or CHA 2 DS 2 VASc-scores, predict major adverse cardiovascular events (MACE) in patients with AF when treated according to current guidelines. Methods: This prospective, longitudinal single-center study included 269 patients with AF. Blood samples were analyzed for sP-Selectin and t-PA-antigen concentration by means of commercially available enzyme-linked immunoassays. Results: Patients were followed for a median duration of 1933 (1517-2277)

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Prognostic value of plasma von Willebrand factor and its cleaving protease ADAMTS13 in patients with atrial fibrillation

Cited by 22 publications

References 43 publications

Clinical and prognostic significance of serum levels of von Willebrand factor and ADAMTS-13 antigens in AL amyloidosis

Clinical and prognostic significance of serum levels of von Willebrand factor and ADAMTS-13 antigens in AL amyloidosis

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

Endogenous t-PA-antigen is an independent predictor of adverse cardiovascular events and all-cause death in patients with atrial fibrillation

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