title: Hypofibrinolysis in atrial fibrillation.
abstract: BACKGROUND
  There is a high incidence of systemic embolism in patients with chronic atrial fibrillation. A hypercoagulable state has been demonstrated, but the fibrinolytic system is rarely studied.
  
  
  METHODS
  Plasma levels of modified antithrombin III (ATM), tissue plasminogen activator (TPA), its inhibitor (PAI-1), TPA-PAI-1 complexes and plasmin-antiplasmin complexes (PAP), d -dimer, and fibrinogen were measured in plasma from 36 patients with chronic atrial fibrillation. Fifteen patients had rheumatic mitral stenosis and 21 had nonrheumatic atrial fibrillation. Levels were compared with those found in the plasma of 20 healthy subjects. Transthoracic echocardiographic studies were done.
  
  
  RESULTS
  Patients with atrial fibrillation had higher plasma levels of ATM, d -dimer, PAI-1, and TPA-PAI-1 complexes than controls (P <.001). The rheumatic atrial fibrillation group also showed elevated levels of fibrinogen (P <. 05). No significant differences were found in TPA and PAP. There were no differences between rheumatic and nonrheumatic atrial fibrillation.
  
  
  CONCLUSIONS
  Atrial fibrillation shows a hypofibrinolytic state caused by elevated PAI-1 levels with no increase in PAP complex concentration. Elevated plasma d -dimer levels suggest increased intravascular thrombogenesis. This may contribute to increased risk of thrombosis.
authors.affiliation: Departments of Hematology and Cardiology, Hospital General Universitario de Alicante, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Roldán
authors.forename: F
authors.initials: F
authors.lastname: Marín
authors.forename: P
authors.initials: P
authors.lastname: Marco
authors.forename: J G
authors.initials: JG
authors.lastname: Martínez
authors.forename: R
authors.initials: R
authors.lastname: Calatayud
authors.forename: F
authors.initials: F
authors.lastname: Sogorb
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents; D000990:Antithrombin III / Q000032:analysis; D001281:Atrial Fibrillation / Q000097:blood / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D005260:Female; D005341:Fibrinolysin / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D000979:alpha-2-Antiplasmin / Q000032:analysis
chemical_list: D000933:Antifibrinolytic Agents; D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D000979:alpha-2-Antiplasmin; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D005341:Fibrinolysin