Effects of anticoagulation intensity on hemostatic markers in patients with non-valvular atrial fibrillation.
BACKGROUND
Elevation of hemostatic markers may account for the increased risk of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF). The aim of this study was to determine the effects of anticoagulation intensity on hemostatic markers in patients with NVAF.


RESULTS
In 509 patients with NVAF, comprising 263 patients treated with warfarin and 246 patients without warfarin, the hemostatic markers of prothrombin fragment F1.2 (F1.2), fibrin D-dimer, platelet factor 4 (PF4), and beta-thromboglobulin were determined and compared with those in 111 patients with sinus rhythm. F1.2 was inversely related with anticoagulation intensity and D-dimer increased with age. All hemostatic markers, except F1.2, were greater in patients with NVAF than in patients with sinus rhythm. F1.2 and D-dimer were significantly lower in patients with international normalized ratio (INR) > or =1.5 than in NVAF patients without warfarin and were not different between NVAF patients with INR of 1.5-1.9 and with INR > or =2.0.


CONCLUSIONS
Low intensity of anticoagulation (INR 1.5-1.9) suppresses the elevated concentration of F1.2 and D-dimer in patients with NVAF, and might be favorable in Japanese patients with NVAF in view of the balance between prevention of thromboembolism and the adverse effect by warfarin (ie, bleeding).
Nozawa
Takashi
T
Second Department of Internal Medicine, Toyama Medical & Pharmaceutical University, Sugitani, Japan.
Inoue
Hiroshi
H
Iwasa
Atsushi
A
Okumura
Ken
K
Jong-dae
Lee
L
Shimizu
Akihiko
A
Hayano
Motonobu
M
Yano
Katsusuke
K
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood* / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006487:Hemostasis; D006801:Humans; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010978:Platelet Factor 4 / Q000032:analysis; D014859:Warfarin / Q000627:therapeutic use*; D001620:beta-Thromboglobulin / Q000032:analysis
D000925:Anticoagulants; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010975:Platelet Aggregation Inhibitors; D001620:beta-Thromboglobulin; C036309:fibrin fragment D; D010978:Platelet Factor 4; D014859:Warfarin