title: Association of platelet activation markers with recurrence of atrial fibrillation after pulmonary vein isolation.
abstract: Atrial fibrillation (AF) is known to cause platelet activation. AF and its degree of thrombogenesis could be associated with monocyte-platelet aggregates (MPAs). We investigated on whether the content of MPAs or other platelet activation markers is associated with the recurrence of AF after pulmonary vein isolation (PVI). A total of 73 patients with symptomatic AF underwent PVI. After 6 months, all patients were evaluated for episodes of AF recurrence. At the same time, flow-cytometric quantification analyses were performed to determine the content of MPAs. Further platelet activation parameters were detected by using either cytometric bead arrays or quantitative immunological determination. Patients with recurrent AF (n = 20) compared to individuals without AF relapse (n = 53) were associated with an increased content of MPAs (43 ± 3% vs. 33 ± 2%, p = 0.004), as well as an increased CD41 expression on monocytes (191 ± 20 vs. 113 ± 6, p = 0.001). The level of the soluble platelet activation markers such as D-dimer, sCD40L, and sP-selectin did not differ between these groups. The content of MPAs correlated weakly with the level of sCD40L (r = 0.26, p = 0.03), but not with sP-selectin and D-dimer, whereas sP-selectin and sCD40L correlated with each other (r = 0.38, p = 0.001). Only the cellular marker of platelet activation, the content of MPAs, was increased in patients with recurrent AF after PVI. In contrast, soluble markers remained unaltered. These data indicate a distinct mechanism and level of platelet activation in AF. The clinical relevance of MPAs in identifying AF recurrence or in guiding the therapy with anticoagulants remains to be elucidated.
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Christian
authors.identifier: http://orcid.org/0000-0001-7504-0435
authors.initials: C
authors.lastname: Pfluecke
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Lina
authors.initials: L
authors.lastname: Plichta
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tarnowski
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Forkmann
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ulbrich
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Silvio
authors.initials: S
authors.lastname: Quick
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Felix M
authors.initials: FM
authors.lastname: Heidrich
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Wiedemann
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Marian
authors.initials: M
authors.lastname: Christoph
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: David M
authors.initials: DM
authors.lastname: Poitz
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Wunderlich
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Strasser
authors.affiliation: a Technische Universität Dresden, Heart Center Dresden , University Hospital , Dresden , Germany.
authors.forename: Karim
authors.initials: K
authors.lastname: Ibrahim
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology*; D011667:Pulmonary Veins / Q000503:physiopathology*; D012008:Recurrence
keywords: atrial fibrillation; monocyte-platelet-aggregates; platelet activation; pulmonary vein isolation; stroke; thrombogenicity