HEMOSTATIC MARKERS AS PROGNOSTIC FACTORS IN ATRIAL FIBRILLATION. PRELIMINARY

CARUSO V; ALBERTO MF; MESCHENGIESER SS; VIZCAICHIPI K; GROSSO S; SÁNCHEZ-LUCEROS A; CASAIS P; HENDLER MF; LAZZARI MA

Suiza

Congreso; XXIst Congress of the International Society on Thrombosis and Haemostasis; 2007

International Society of Thrombosis and Haemostasis

Introduction: The aim of this ongoing prospective study is to assess the value of measuring markers of clotting activation (D-Dimer (DD)) and endothelial dysfunction (von Willebrand Factor (VWF)) along with fibrinogen (Fib) as prognostic information in atrial fibrillation (AF). Preliminary findings at baseline are here described. Methods: Patients with diagnosis of AF were included, obtaining clinical and echocardiogram data along with samples for markers measuring. They received anticoagulation based on their cardiologists decision. Subjects will be followed-up for at least two years for thrombotic events, and markers will be measured every 6 months. Enzyme immunoassay was used for measuring DD (VIDAS DD Exclusion, bioMérieux) and VWF. Fib was determined by the Clauss method. Pearson method was used for correlations. T-test and ANOVA were used to compare means. Results: Thirty seven patients have been currently included. Mean values for Fib, DD and VWF were 355109 mg/dl (normal: 200-400), 725366 ng/ml (normal: <500) and 11118% (normal: 50-150) respectively; 70% of DD values were above the cut-off level. A positive correlation was found between Fib and DD (P=0.05). Main results of subgroup analyses are shown in the table. No significant association was found between markers and echocardiogram data. Table        N VWF(%) DD(ng/ml) Fib(mg/ml) Risk by CHADS2 Score Low 10 11919 577353 18765 Moderate 23 10817 792356 388120 High 4 10922 854447 37036 P 0.3 0.2 0.05 Aspirin at baseline Yes 22 11420 671297 355109 No 15 10917 811455 355112 P 0.5 0.3 1        Conclusions: Levels of Fib and DD seem to increase in AF, being still higher in patients with elevated thrombotic risk based on clinical criteria (CHADS2 Score). Although non-statistically significant, patients receiving aspirin tend to have lower DD values. VWF levels were similar in all groups, suggesting a minimal role of endothelial dysfunction in AF. Further follow-up may possibly assess the contribution of these hemostatic markers to AF risk stratification and treatment decision. N VWF(%) DD(ng/ml) Fib(mg/ml) Risk by CHADS2 Score Low 10 11919 577353 18765 Moderate 23 10817 792356 388120 High 4 10922 854447 37036 P 0.3 0.2 0.05 Aspirin at baseline Yes 22 11420 671297 355109 No 15 10917 811455 355112 P