Increased intracardiovascular clotting in patients with chronic atrial fibrillation

Division of Cardiology, Osaka Prefectural Hospital, Japan.

To clarify whether the formation of thrombi could be induced by atrial fibrillation itself or by factors predisposing to atrial fibrillation such as mitral stenosis, plasma D-dimer levels (cross-linked fibrin degradation products) were measured in 73 patients without atrial fibrillation (Group 2). In Group 1, 49 of the 73 patients had factors predisposing to atrial fibrillation such as valvular heart disease, and the remaining 24 had lone atrial fibrillation. In Group 2, 16 patients had organic heart disease and the remaining 5 had a chest pain syndrome. The plasma D-dimer level was significantly higher in Group 1 (150 +/- 19 ng/ml) than in Group 2 (61 +/- 3 ng/ml) (p less than 0.01, mean +/- standard error of the mean). In both groups, there were no significant differences in plasma D-dimer level between patients with and without organic heart disease (146 +/- 18 versus 156 +/- 46 ng/ml in Group 1; 61 +/- 4 versus 59 +/- 10 ng/ml in Group 2). These findings indicate that atrial fibrillation itself may be more important than factors predisposing to atrial fibrillation in the development of intracardiovascular clotting.

This article has been cited by other articles:

				A. Goette, A. Bukowska, U. Lendeckel, M. Erxleben, M. Hammwohner, D. Strugala, J. Pfeiffenberger, F.-W. Rohl, C. Huth, M. P.A. Ebert, et al. Angiotensin II Receptor Blockade Reduces Tachycardia-Induced Atrial Adhesion Molecule Expression Circulation, February 12, 2008; 117(6): 732 - 742. [Abstract] [Full Text] [PDF]

				M. Hammwohner, A. Ittenson, J. Dierkes, A. Bukowska, H. U. Klein, U. Lendeckel, and A. Goette Platelet Expression of CD40/CD40 Ligand and Its Relation to Inflammatory Markers and Adhesion Molecules in Patients with Atrial Fibrillation Experimental Biology and Medicine, April 1, 2007; 232(4): 581 - 589. [Abstract] [Full Text] [PDF]

				Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]

				V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]

				V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]

				F Marin, V Roldan, V E Climent, A Ibanez, A Garcia, P Marco, F Sogorb, and G Y H Lip Plasma von Willebrand factor, soluble thrombomodulin, and fibrin D-dimer concentrations in acute onset non-rheumatic atrial fibrillation Heart, October 1, 2004; 90(10): 1162 - 1166. [Abstract] [Full Text] [PDF]

				H. Inoue, T. Nozawa, K. Okumura, L. Jong-Dae, A. Shimizu, and K. Yano Prothrombotic Activity Is Increased in Patients With Nonvalvular Atrial Fibrillation and Risk Factors for Embolism Chest, September 1, 2004; 126(3): 687 - 692. [Abstract] [Full Text] [PDF]

				D. S. G. Conway, P. Buggins, E. Hughes, and G. Y. H. Lip Relationship of interleukin-6 and C-Reactive protein to the prothrombotic state in chronic atrial fibrillation J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2075 - 2082. [Abstract] [Full Text] [PDF]

				D. S.G. Conway, L. A. Pearce, B. S.P. Chin, R. G. Hart, and G. Y.H. Lip Prognostic Value of Plasma von Willebrand Factor and Soluble P-Selectin as Indices of Endothelial Damage and Platelet Activation in 994 Patients With Nonvalvular Atrial Fibrillation Circulation, July 1, 2003; 107(25): 3141 - 3145. [Abstract] [Full Text] [PDF]

				D. S.G. Conway, J. Heeringa, D. A.M. Van Der Kuip, B. S.P. Chin, A. Hofman, J. C.M. Witteman, and G. Y.H. Lip Atrial Fibrillation and the Prothrombotic State in the Elderly: The Rotterdam Study Stroke, February 1, 2003; 34(2): 413 - 417. [Abstract] [Full Text] [PDF]

				W. Ageno, S. Finazzi, L. Steidl, M. G. Biotti, V. Mera, G. Melzi d'Eril, and A. Venco Plasma Measurement of D-Dimer Levels for the Early Diagnosis of Ischemic Stroke Subtypes Arch Intern Med, December 9, 2002; 162(22): 2589 - 2593. [Abstract] [Full Text] [PDF]

				D. S.G. Conway, L. A. Pearce, B. S.P. Chin, R. G. Hart, and G. Y.H. Lip Plasma von Willebrand Factor and Soluble P-Selectin as Indices of Endothelial Damage and Platelet Activation in 1321 Patients With Nonvalvular Atrial Fibrillation: Relationship to Stroke Risk Factors Circulation, October 8, 2002; 106(15): 1962 - 1967. [Abstract] [Full Text] [PDF]

				S. Kamath, A. D. Blann, B. S. P. Chin, and G. Y. H. Lip A prospective randomized trial of aspirin-clopidogrel combination therapy and dose-adjusted warfarin on indices of thrombogenesis and platelet activation in atrial fibrillation J. Am. Coll. Cardiol., August 7, 2002; 40(3): 484 - 490. [Abstract] [Full Text] [PDF]

				K. Nakagawa, T. Hirai, N. Shinokawa, S. Takashima, T. Nozawa, H. Asanoi, and H. Inoue Aortic Spontaneous Echocardiographic Contrast and Hemostatic Markers in Patients With Nonrheumatic Atrial Fibrillation Chest, February 1, 2002; 121(2): 500 - 505. [Abstract] [Full Text] [PDF]

				D. Horstkotte, D. Hering, L. Faber, and C. Piper Cardiac morphology and physiology predisposing to thrombus formation Eur. Heart J. Suppl., December 1, 2001; 3(suppl_Q): Q8 - Q11. [Abstract] [PDF]

				F. L. Li-Saw-Hee, A. D. Blann, and G. Y. H. Lip A cross-sectional and diurnal study of thrombogenesis among patients with chronic atrial fibrillation J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1926 - 1931. [Abstract] [Full Text] [PDF]

				F. L. Li-Saw-Hee, A. D. Blann, and G. Y. H. Lip Effects of Fixed Low-Dose Warfarin, Aspirin-Warfarin Combination Therapy, and Dose-Adjusted Warfarin on Thrombogenesis in Chronic Atrial Fibrillation Stroke, April 1, 2000; 31(4): 828 - 833. [Abstract] [Full Text] [PDF]

				T. Minamino, M. Kitakaze, S. Sanada, H. Asanuama, T. Kurotobi, Y. Koretsune, M. Fukunami, T. Kuzuya, N. Hoki, and M. Hori Increased Expression of P-Selectin on Platelets Is a Risk Factor for Silent Cerebral Infarction in Patients With Atrial Fibrillation : Role of Nitric Oxide Circulation, October 27, 1998; 98(17): 1721 - 1727. [Abstract] [Full Text] [PDF]

				T. Minamino, M. Kitakaze, H. Sato, H. Asanuma, H. Funaya, Y. Koretsune, and M. Hori Plasma Levels of Nitrite/Nitrate and Platelet cGMP Levels Are Decreased in Patients With Atrial Fibrillation Arterioscler Thromb Vasc Biol, November 1, 1997; 17(11): 3191 - 3195. [Abstract] [Full Text]

				C. Giansante, N. Fiotti, S. Calabrese, R. La Verde, C. Pandullo, S. Scardi, and G. Guarnieri D-Dimer and Anticoagulation in Patients With Mechanical Prosthetic Heart Valves : A 2-Year Follow-up Arterioscler Thromb Vasc Biol, July 1, 1997; 17(7): 1320 - 1324. [Abstract] [Full Text]

				G. Y.H. Lip, P. L. Lip, J. Zarifis, R. D.S. Watson, D. Bareford, G. D.O. Lowe, and D. G. Beevers Fibrin D-Dimer and ß-Thromboglobulin as Markers of Thrombogenesis and Platelet Activation in Atrial Fibrillation: Effects of Introducing Ultra–Low-Dose Warfarin and Aspirin Circulation, August 1, 1996; 94(3): 425 - 431. [Abstract] [Full Text]