title: Impact of Atrial Fibrillation and Sinus Rhythm Restoration on Reticulated Platelets.
abstract: OBJECTIVE
  To assess the impact of nonvalvular atrial fibrillation (NVAF) and sinus rhythm restoration on the distribution of reticulated platelets (RPs), which are known to be associated with thrombotic propensity and have a greater predilection for thrombus participation.
  
  
  METHODS
  The RP content was assessed by flow cytometry (thiazole orange/CD61) in 110 consecutive patients with NVAF before and 3 to 4 months after catheter ablation of the pulmonary veins. Results were compared with those of 55 age- and sex-matched controls with normal sinus rhythm.
  
  
  RESULTS
  The mean ± SD percentage of RPs was higher in patients with NVAF compared with controls (28.5%±7.3% vs 6.4%±5.3%; P<.001). The RP content did not vary by CHA2DS2-VASc score. After catheter ablation of the pulmonary veins, 63 patients were available for follow-up assessment. A significant reduction of RPs was observed compared with preintervention values (29.85%±7.1% vs 20.79%±7.6%; P<.001). During follow-up, 19% of patients (12 of 63) had confirmed AF recurrence. The mean ± SD percentage of RPs was higher in this group than in those without a recurrence (24.7%±6.5% vs 18.9%±7.5%; P=.01).
  
  
  CONCLUSIONS
  Nonvalvular atrial fibrillation affects the percentage of RPs, independent of the CHA2DS2-VASc score. After ablation, RP content dropped significantly. High RP content in patients with NVAF may explain the potential mechanism of thromboembolic complications and the lack of efficacy of currently available antiplatelet therapy for stroke prevention in this dysrhythmia.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Alfonso J
authors.initials: AJ
authors.lastname: Tafur
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Robert D
authors.initials: RD
authors.lastname: McBane
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Naser
authors.initials: N
authors.lastname: Ammash
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.affiliation: Department of Laboratory Medicine and Pathology, Special Coagulation Laboratory, Mayo Clinic, Rochester, MN.
authors.forename: Randall D
authors.initials: RD
authors.lastname: Miller
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Dawid
authors.initials: D
authors.lastname: Janczak
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Slusser
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Grill
authors.affiliation: Department of Laboratory Medicine and Pathology, Special Coagulation Laboratory, Mayo Clinic, Rochester, MN.
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Whelan
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Electronic address: wysokinski.waldemar@mayo.edu.
authors.forename: Waldemar E
authors.initials: WE
authors.lastname: Wysokinski
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D001792:Blood Platelets / Q000502:physiology*; D016022:Case-Control Studies; D017115:Catheter Ablation; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D020521:Stroke / Q000209:etiology / Q000503:physiopathology; D013923:Thromboembolism / Q000209:etiology / Q000503:physiopathology