Document Detail

Impact of decreased renal function on coagulation and fibrinolysis in patients with non-valvular atrial fibrillation.
MedLine Citation:
PMID:  19346661     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The prothrombotic state in non-valvular atrial fibrillation (NVAF) increases the risk of thromboembolic events. It is also well known that a prothrombotic state exists in renal failure. Hemostatic disorders play a role in thromboembolic mortality in both NVAF and renal failure. However, little is known about the influence of renal function on hemostasis in patients with NVAF. METHODS AND RESULTS: A total of 190 consecutive outpatients with NVAF who were not receiving anticoagulant therapy were enrolled in the present study. Patients were stratified in groups based on estimated glomerular filtration rate (eGFR). Plasma concentrations of thrombin-antithrombin complex (TAT) and D-dimer were measured and the influence of renal function on coagulation and fibrinolysis was assessed. A relatively weak and inverse relationship of eGFR to TAT and D-dimer was observed (r=0.28, P=0.0001; r=0.30, P<0.0001). Both mean TAT and D-dimer concentrations in groups gradually and significantly increased as eGFR decreased (P<0.0001). On multivariate regression analysis, decreased eGFR concentration was a significant predictor for elevation of TAT (P<0.05) and D-dimer (P<0.01) in patients with NVAF. CONCLUSIONS: The enhanced coagulation activation appeared to be related to a reduction in residual renal function in patients with NVAF. This suggests that decreased renal function might be a candidate predictor of thromboembolic events in patients with NVAF.
Hideki Tanaka; Masahiro Sonoda; Katsuro Kashima; Yasuhiro Tanaka; Kazuhiko Nakamura; Norihito Nuruki; Hirohito Tsubouchi
Publication Detail:
Type:  Journal Article     Date:  2009-04-06
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  846-50     Citation Subset:  IM    
The Second Department of Cardiology, National Hospital Organization Kagoshima Medical Center, Japan.
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MeSH Terms
Aged, 80 and over
Antithrombin III
Atrial Fibrillation / blood,  complications*,  physiopathology
Biological Markers / blood
Blood Coagulation*
Fibrin Fibrinogen Degradation Products / analysis
Glomerular Filtration Rate
Kidney / physiopathology*
Kidney Diseases / blood,  complications*,  physiopathology
Linear Models
Middle Aged
Peptide Hydrolases / blood
Risk Assessment
Risk Factors
Thrombosis / blood,  etiology*,  physiopathology
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/antithrombin III-protease complex; 0/fibrin fragment D; 9000-94-6/Antithrombin III; EC 3.4.-/Peptide Hydrolases

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