Prothrombotic activity is increased in patients with nonvalvular atrial fibrillation and risk factors for embolism.
OBJECTIVE
The aim of this study was to investigate whether risk factors for embolism would promote thrombus formation in patients with nonvalvular atrial fibrillation (NVAF).


METHODS
Hemostatic markers for platelet activity (ie, platelet factor-4 and beta-thromboglobulin [TG]), thrombotic status (ie, prothombin fragments 1 and 2), and fibrinolytic status (ie, d-dimer) were determined in 246 patients with NVAF (mean age, 66.1 years) and 111 control subjects without NVAF (68.3 years).


RESULTS
The beta-TG level was higher in NVAF patients than in control subjects. D-dimer levels were higher in NVAF patients having risk factors (mean [+/- SE] d-dimer level, 158.6 +/- 9.2 ng/mL) than in those without risk factors (mean d-dimer level, 92.1 +/- 6.7 ng/mL; p < 0.01) and in control subjects (mean d-dimer level: control subjects with risk factors, 79.1 +/- 10.3 ng/mL; control subjects without risk factors, 31.0 +/- 7.4 ng/mL; p < 0.01). NVAF (odds ratio [OR], 3.94; 95% confidence interval [CI], 1.87 to 8.30; p = 0.0003) and age of >/= 75 years (OR, 5.68; 95% CI, 2.87 to 11.23; p < 0.0001) emerged as predictors of elevated levels of d-dimer, and only NVAF (OR, 10.30; 95% CI, 5.67 to 18.72; p < 0.0001) emerged as a predictor of elevated levels of beta-TG.


CONCLUSIONS
NVAF patients whose conditions were complicated with risk factors for embolism could be in the prothrombotic state. Advanced age is a strong predictor of the prothrombotic state in NVAF patients.
Inoue
Hiroshi
H
The Second Department of Internal Medicine, Toyama Medical & Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
Nozawa
Takashi
T
Okumura
Ken
K
Jong-Dae
Lee
L
Shimizu
Akihiko
A
Yano
Katsusuke
K
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000209:etiology; D004617:Embolism / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011516:Prothrombin / Q000032:analysis*; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood* / Q000175:diagnosis; D001620:beta-Thromboglobulin / Q000032:analysis
D005338:Fibrin Fibrinogen Degradation Products; D001620:beta-Thromboglobulin; C036309:fibrin fragment D; D011516:Prothrombin