Document Detail


Plasma von Willebrand factor, soluble thrombomodulin, and fibrin D-dimer concentrations in acute onset non-rheumatic atrial fibrillation.
MedLine Citation:
PMID:  15367514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether new onset acute atrial fibrillation (AF) of < 48 hours' duration creates a prothrombotic state in the absence of anticoagulation and to assess the evolution in research indices after spontaneous or pharmacological cardioversion.
METHODS: 24 patients were recruited with first onset acute non-rheumatic AF, in whom sinus rhythm was restored within 48 hours of arrhythmia onset, without anticoagulant treatment. Atrial mechanical function was assessed by transmitral inflow. Soluble thrombomodulin and von Willebrand factor concentrations (both as indices of endothelial damage or dysfunction) and fibrin D-dimer concentrations (as an index of thrombogenesis) were measured. Blood samples were drawn and echocardiographic studies were performed at days 1, 3, 7, and 30 after cardioversion. Research indices were compared with those of 24 healthy participants, 24 patients with chronic AF, and 24 patients with ischaemic heart disease in sinus rhythm.
RESULTS: Patients with AF had higher concentrations of soluble thrombomodulin (acute AF 12.1 (4.1) ng/ml; chronic AF 11.8 (4.6) ng/ml), von Willebrand factor (acute AF 137.2 (36.9) ng/ml; chronic AF 133.1 (25.0) ng/ml), and fibrin D-dimer concentrations (acute AF 2.35 (2.68) microg/ml; chronic AF 1.12 (0.65) microg/ml) than did healthy controls (5.9 (2.7) ng/ml, 86.7 (33.2) ng/ml, and 0.39 (0.28) microg/ml, respectively) and patients with ischaemic heart disease (7.4 (3.7) ng/ml, 110.0 (29.0) ng/ml, and 0.99 (0.73) microg/ml, respectively) (all p < 0.05). Day 30 concentrations of fibrin D-dimer were higher in patients with acute AF than in patients with chronic AF (p = 0.038) but sTM and von Willebrand factor concentrations were not different (both not significant). There were no significant changes in research indices or echocardiographic parameters after cardioversion (all p > 0.05).
CONCLUSIONS: There was evidence among patients with acute onset AF of endothelial damage or dysfunction and increased thrombogenesis, which persisted up to 30 days after cardioversion.
Authors:
F Marín; V Roldán; V E Climent; A Ibáñez; A García; P Marco; F Sogorb; G Y H Lip
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  90     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-15     Completed Date:  2004-10-04     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1162-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, General Hospital of Alicante, Pintor Baeza s/n, Alicante 03002, Spain. fcomarino@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Anticoagulants / therapeutic use
Atrial Fibrillation / blood*,  therapy,  ultrasonography
Echocardiography, Doppler
Electric Countershock
Epidemiologic Studies
Female
Fibrin Fibrinogen Degradation Products / analysis*
Humans
Male
Middle Aged
Risk
Thrombomodulin / analysis*
Thrombosis / blood
von Willebrand Factor / analysis*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrin Fibrinogen Degradation Products; 0/Thrombomodulin; 0/fibrin fragment D; 0/von Willebrand Factor
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