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Hypofibrinolysis in atrial fibrillation
1Departments of Hematology and Cardiology, Hospital General Universitario de Alicante, Spain.
American Heart Journal
|December 8, 1998
Summary
Patients with atrial fibrillation exhibit a hypofibrinolytic state, indicated by elevated plasminogen activator inhibitor-1 (PAI-1) and increased d-dimer levels, suggesting a higher risk of thrombosis.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Thrombosis Research
Background:
- Atrial fibrillation is linked to a high incidence of systemic embolism.
- A hypercoagulable state is known in atrial fibrillation, but the fibrinolytic system is understudied.
Purpose of the Study:
- To investigate the fibrinolytic system in patients with chronic atrial fibrillation.
- To compare fibrinolytic markers between patients with rheumatic and nonrheumatic atrial fibrillation and healthy controls.
Main Methods:
- Plasma levels of antithrombin III (ATM), tissue plasminogen activator (TPA), plasminogen activator inhibitor-1 (PAI-1), TPA-PAI-1 complexes, plasmin-antiplasmin complexes (PAP), d-dimer, and fibrinogen were measured.
- 36 patients with chronic atrial fibrillation (15 rheumatic, 21 nonrheumatic) and 20 healthy controls were studied.
- Transthoracic echocardiography was performed.
Main Results:
- Patients with atrial fibrillation showed higher plasma levels of ATM, d-dimer, PAI-1, and TPA-PAI-1 complexes compared to controls.
- The rheumatic atrial fibrillation group had elevated fibrinogen levels.
- No significant differences were observed in TPA and PAP levels, nor between rheumatic and nonrheumatic atrial fibrillation groups.
Conclusions:
- Atrial fibrillation is associated with a hypofibrinolytic state due to elevated PAI-1.
- Increased plasma d-dimer levels indicate heightened intravascular thrombogenesis.
- These findings suggest an increased risk of thrombosis in patients with atrial fibrillation.