Document Detail


Markers of thrombin and platelet activity in patients with atrial fibrillation: correlation with stroke among 1531 participants in the stroke prevention in atrial fibrillation III study.
MedLine Citation:
PMID:  10582976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Markers of thrombin generation and platelet activation are often elevated in patients with nonvalvular atrial fibrillation, but it is unclear whether such markers usefully predict stroke. Therefore, we undertook the present study to assess the relationship between prothrombin fragment F1.2 (F1.2), beta-thromboglobulin (BTG), fibrinogen, and the factor V Leiden mutation with stroke in atrial fibrillation. METHODS: Specimens were obtained from 1531 participants in the Stroke Prevention in Atrial Fibrillation III study. The results were correlated with patient features, antithrombotic therapy, and subsequent thromboembolism (ischemic stroke and systemic embolism) by multivariate analysis. RESULTS: Increased F1.2 levels were associated with age (P<0.001), female sex (P<0.001), systolic blood pressure (P=0.006), and heart failure (P=0.001). F1.2 were not affected by aspirin use and were not associated with thromboembolism after adjustment for age (P=0. 18). BTG levels were higher with advanced age (P=0.006), coronary artery disease (P=0.05), carotid disease (P=0.005), and heart failure (P<0.001), lower in regular alcohol users (P=0.05), and not significantly associated with thromboembolism. Fibrinogen levels were not significantly related to thromboembolism but were associated with elevated BTG levels (P<0.001). The factor V Leiden mutation was not associated with thromboembolism (relative risk 0.5, 95% CI 0.1 to 3.8). CONCLUSIONS: Elevated F1.2 levels were associated with clinical risk factors for stroke in atrial fibrillation, whereas increased BTG levels were linked to manifestations of atherosclerosis. In this large cohort of patients with atrial fibrillation who were receiving aspirin, F1.2, BTG, fibrinogen, and factor V Leiden were not independent, clinically useful predictors of stroke.
Authors:
W M Feinberg; L A Pearce; R G Hart; M Cushman; E S Cornell; G Y Lip; E G Bovill
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  30     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1999 Dec 
Date Detail:
Created Date:  1999-12-10     Completed Date:  1999-12-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2547-53     Citation Subset:  IM    
Affiliation:
Department of Neurology, the University of Arizona, Tucson, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Anticoagulants / administration & dosage
Aspirin / administration & dosage
Atrial Fibrillation / blood*
Biological Markers / blood
Factor V / analysis*
Female
Fibrinogen / analysis*
Fibrinolytic Agents / administration & dosage
Humans
Male
Middle Aged
Multivariate Analysis
Peptide Fragments / analysis*
Phlebotomy
Prothrombin / analysis*
Sex Factors
Stroke / blood*
Thromboembolism / blood
Warfarin / administration & dosage
beta-Thromboglobulin / analysis*
Grant Support
ID/Acronym/Agency:
R01 NS24224/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Biological Markers; 0/Fibrinolytic Agents; 0/Peptide Fragments; 0/beta-Thromboglobulin; 0/factor V Leiden; 0/prothrombin fragment 1.2; 50-78-2/Aspirin; 81-81-2/Warfarin; 9001-24-5/Factor V; 9001-26-7/Prothrombin; 9001-32-5/Fibrinogen

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


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