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  11. Elevated Plasma Protein Carbonylation Increases The Risk Of Ischemic Cerebrovascular Events In Patients With Atrial Fibrillation: Association With A Prothrombotic State

Elevated plasma protein carbonylation increases the risk of ischemic cerebrovascular events in patients with atrial fibrillation: association with a prothrombotic state

Karol Nowak1,2, Michal Zabczyk1,3, Joanna Natorska1,3

  • 1Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Pradnicka 80 St, 31-202, Kraków, Poland.

Journal of Thrombosis and Thrombolysis
|July 4, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Elevated protein carbonylation (PC) levels in atrial fibrillation (AF) patients predict a higher risk of ischemic stroke, even with anticoagulation. This increased risk is linked to unfavorable changes in fibrin clot structure.

Area of Science:

  • Biochemistry
  • Cardiology
  • Hematology

Background:

  • Oxidative stress, indicated by plasma protein carbonylation (PC), is linked to a prothrombotic fibrin clot phenotype.
  • The predictive role of PC for ischemic stroke in atrial fibrillation (AF) patients on anticoagulation remains largely unknown.

Purpose of the Study:

  • To investigate whether plasma PC levels predict the risk of ischemic stroke in anticoagulated AF patients.
  • To explore the association between PC and fibrin clot properties, thrombin generation, and fibrinolytic proteins.

Main Methods:

  • Plasma PC was measured in 243 anticoagulated AF patients using the Becatti assay.
  • Clot permeability (Ks), clot lysis time (CLT), thrombin generation, and fibrinolytic proteins were assessed.
  • Ischemic stroke, major bleeding, and mortality were recorded during a median 53-month follow-up.
Keywords:
Atrial fibrillationEndogenous thrombin potentialFibrin clotProtein carbonylation

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Main Results:

  • Higher baseline PC levels were associated with age, CHA2DS2-VASc score, and heart failure.
  • PC levels correlated positively with CLT and endogenous thrombin potential, and negatively with Ks.
  • Patients who experienced stroke had significantly higher baseline PC levels and elevated PC was independently associated with stroke risk.

Conclusions:

  • Enhanced protein carbonylation is associated with an increased residual risk of stroke in AF patients, despite anticoagulation.
  • This elevated risk is partly attributed to an unfavorable fibrin clot phenotype.
Stroke