Author + information
- Jeffrey Liles,
- Christopher Wanderling,
- Sallu Jabati,
- Timothy Rowe,
- Abigail Otto,
- Jack Bonteckoe,
- Debra Hoppensteadt,
- Mushabbar Syed and
- Jawed Fareed
Background: Despite its effectiveness, new oral anticoagulants (nOACs) have replaced warfarin for management of thrombotic and cardiovascular disorders including atrial fibrillation (AF). Previous research has shown increased levels of thrombogenic biomarkers in patients with AF in spite of nOAC use. Additional markers of thrombogenesis have yet to be examined including extracellular nucleosomes which mediate inflammatory and thromobotic responses and could serve as a marker of thrombosis in AF.
Methods: Citrated blood samples were drawn from 50 patients prior to ablation surgery for AF. Normal plasma samples were collected from young normals (mean age 33, n=50) and age matched normals (mean age 65.6, n=24). The plasma samples were analyzed with ELISA kits for vWF, D-dimer, nucleosome, and prothrombin fragment 1.2 (F1.2).
Results: No difference was seen in the level of vWF or D-dimer between the young normals and age matched normals (p=0.68, 0.11). Age matched normals were elevated compared to young normals for level of nucleosome (p<0.0001). Compared to the control group, levels of vWF were statistically increased in patients with AF (P=0.0002). D-dimer, nucleosome, and prothrombin F1.2 showed no difference between the AF and the control group (P=0.86, p=0.09, p=0.68). When AF patients (n=50) were divided into two groups based on their usage (n=30) and non-usage (n=20) of any nOAC, a statistical increase in vWF (p<0.0001) and nucleosome (p=0.04) was seen in the AF group taking nOACs compared to the control group. F1.2 was statistically increased in the AF group not taking nOAC's compared to the control.
Conclusions: Elevated levels of vWF seen in AF patients compared to normal provide insight into an additional risk of thrombogenesis associated with AF not currently targeted by nOAC's. Patients in not receiving nOAC's had a mean CHA2DS2VASc score of 1.05 compared to 2.17 seen in the AF group receiving nOAC's. Although effective in lowering prothrombin F1.2 levels in AF, the nOAC's still leave additional prothrombotic biomarkers unaffected which could be the potential target of future drug therapies to lower the risk of stroke in patients with AF even more than the use of newer anticoagulants alone.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Fibrillatory Arrhythmias: Outcomes With Contemporary Practice
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1110-109
- 2017 American College of Cardiology Foundation