title: Impact of atrial fibrillation on inflammatory and fibrinolytic variables in the elderly.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is associated with inflammation and a prothrombotic state; however, it is still unclear whether this is independent of ageing and comorbidity. The objective of this study was to investigate the impact of AF on circulating levels of inflammatory and fibrinolytic markers in a 75-year-old general population.
  
  
  METHODS
  All 75-year-old citizens in Asker and Baerum counties in Norway were invited to participate in a prevalence study of AF. Blood samples were collected from 63 subjects with AF and a gender-matched control group of 126 subjects in sinus rhythm. C-reactive protein (CRP), tumour necrosis factor α (TNFα), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), P-selectin, CD40 ligand, tissue plasminogen activator antigen (tPA ag), plasminogen activator inhibitor-1 (PAI-1), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase inhibitor 1 (TIMP-1) activity were analyzed using commercially available assays.
  
  
  RESULTS
  Subjects with AF had higher levels of IL-6 (median 3.07 pg/mL (interquartile range 2.11, 4.36) vs. 2.26 (1.70, 3.26); p = 0.002) and PAI-1 activity (12.9 U/mL (6.6, 17.1) vs. 9.0 (4.6, 14.0); p = 0.005). No difference was found for the other markers. The presence of AF was still significantly associated with higher levels of IL-6 and PAI-1 activity after adjusting for confounders (p = 0.028 and p = 0.007, respectively).
  
  
  CONCLUSIONS
  AF was independently associated with higher levels of IL-6 and PAI-1 activity. Thus, there is evidence of a proinflammatory state and reduced fibrinolysis also in this stable, out-of-hospital group of 75-year-old AF patients.
authors.affiliation: a Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital , Rud.
authors.forename: Trygve
authors.initials: T
authors.lastname: Berge
authors.affiliation: a Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital , Rud.
authors.forename: Sara R
authors.initials: SR
authors.lastname: Ulimoen
authors.affiliation: a Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital , Rud.
authors.forename: Steve
authors.initials: S
authors.lastname: Enger
authors.affiliation: b Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål , Oslo.|c Faculty of Medicine, University of Oslo , Oslo, Norway.
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.affiliation: b Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål , Oslo.|c Faculty of Medicine, University of Oslo , Oslo, Norway.
authors.forename: Ingebjørg
authors.initials: I
authors.lastname: Seljeflot
authors.affiliation: a Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital , Rud.
authors.forename: Arnljot
authors.initials: A
authors.lastname: Tveit
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D009664:Norway; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: Atrial fibrillation; C-reactive protein; cardiology; inflammation mediators; interleukin-6; plasminogen activator inhibitor 1