Document Detail

Accumulation of risk factors enhances the prothrombotic state in atrial fibrillation.
MedLine Citation:
PMID:  17689760     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The present study was conducted to investigate the relation between the accumulation of the risk factors of thromboembolism and the levels of hemostatic markers in patients with nonvalvular atrial fibrillation (NVAF). METHODS: Five hundred ninety-one NVAF patients and 129 control subjects were categorized into low, moderate or high risk of thromboembolism, according to CHADS(2) index. One point each was given to patients with advanced age (> or =75 years), hypertension, congestive heart failure, and diabetes mellitus, and 2 points, to those with prior ischemic stroke or transient ischemic attack. Patients with CHADS(2) score of 0, 1 or 2, and > or =3 were classified as low, moderate and high risk, respectively. Levels of hemostatic markers (platelet factor 4, beta-thromboglobulin, prothrombin fragment F1+2 and D-dimer) were determined. RESULTS: Of 591 patients with NVAF, 302 were treated with warfarin (mean international normalized ratio 1.88). D-dimer levels increased as the risk level increased irrespective of warfarin use. Particularly, NVAF patients without receiving warfarin (n=289) had significantly higher D-dimer levels than control patients (e.g., for high risk patients, 175+/-144 vs 75+/-87 ng/ml, p<0.001), while NVAF patients receiving warfarin had intermediate levels (136+/-156 ng/ml). F1+2 levels increased as the risk level increased, and were significantly suppressed by warfarin. Levels of markers of platelet activation (platelet factor 4 and beta-thromboglobulin) were increased in NVAF patients but not affected by the risk level. CONCLUSION: Coagulation and fibrinolytic activity is increased along with the accumulation of the risk factors of thromboembolism in NVAF patients.
Kazumasa Ohara; Hiroshi Inoue; Takashi Nozawa; Tadakazu Hirai; Atsushi Iwasa; Ken Okumura; Jong-Dae Lee; Akihiko Shimizu; Motonobu Hayano; Katsusuke Yano
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-08
Journal Detail:
Title:  International journal of cardiology     Volume:  126     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-16     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  316-21     Citation Subset:  IM    
Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
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MeSH Terms
Age Distribution
Anticoagulants / therapeutic use*
Atrial Fibrillation / diagnosis,  epidemiology*
Case-Control Studies
Fibrin Fibrinogen Degradation Products / analysis*
Follow-Up Studies
Middle Aged
Platelet Factor 4 / analysis
Prothrombin / analysis
Reference Values
Risk Assessment
Severity of Illness Index
Sex Distribution
Stroke / etiology,  prevention & control*
Survival Analysis
Thromboembolism / diagnosis,  drug therapy*,  epidemiology*
Warfarin / therapeutic use
beta-Thromboglobulin / analysis
Reg. No./Substance:
0/Anticoagulants; 0/Fibrin Fibrinogen Degradation Products; 0/beta-Thromboglobulin; 0/fibrin fragment D; 37270-94-3/Platelet Factor 4; 81-81-2/Warfarin; 9001-26-7/Prothrombin
Comment In:
Int J Cardiol. 2008 Jun 6;126(3):299-301   [PMID:  18077017 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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