Colkesen Yucel, Acil Tayfun, Abayli Bahri, Yigit Fatma, Katircibasi Tuna, Kocum Tolga, Demircan Senol, Sezgin Alpay, Ozin Bulent, Muderrisoglu Haldun
Department of Cardiology, Faculty of Medicine, Baskent University, Turkey.
Blood Coagul Fibrinolysis. 2008 Jul;19(5):411-4. doi: 10.1097/MBC.0b013e3283049697.
Paroxysmal atrial fibrillation might be a risk factor for stroke such as chronic atrial fibrillation. We examined the relation between mean platelet volume and paroxysmal atrial fibrillation to determine the effect of paroxysmal atrial fibrillation on the thrombotic state via elevated mean platelet volume. Mean platelet volume is a marker of platelet size, function, and activation. Increased mean platelet volume reflects active and large platelets that release more thromboxane A2 than smaller ones. We hypothesized that mean platelet volume is elevated in patients with paroxysmal atrial fibrillation. The study population comprised 103 consecutive patients who were detected to have paroxysmal atrial fibrillation by 24-h Holter monitoring and 87 control individuals with normal Holter monitoring. Mean platelet volume and inflammatory parameters were measured. Comprehensive clinical and echocardiographic data were collected. Patients with aortic and mitral stenosis, hyperthyroidism, hypothyroidism, malignancy, infection, and pregnancy were excluded from the study. Mean age of the patients was 63 +/- 11 vs. 45 +/- 14 years (P < 0.001) in paroxysmal atrial fibrillation and control groups, respectively. Fifty-seven patients (55%) in paroxysmal atrial fibrillation and 19 (21%) (P < 0.001) patients in control group were men. Mean platelet volume was significantly higher in the paroxysmal atrial fibrillation group when compared with control group (10.0 +/- 2.0 vs. 8.3 +/- 1.5 fl, respectively; P < 0.001). C-reactive protein (18.5 +/- 28 vs. 3.8 +/- 2 mg/l, respectively; P = 0.004) and erythrocyte sedimentation rate (21 +/- 21 vs. 12 +/- 7 mm/h, respectively; P = 0.01) were also higher in the paroxysmal atrial fibrillation group. There was no difference in white blood cell and platelet counts between groups. In a multivariate analysis, elevated mean platelet volume was associated with the occurrence of paroxysmal atrial fibrillation before and after adjustment for age and sex. Our results indicate that inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate and the marker of platelet size and activity mean platelet volume are elevated in patients with paroxysmal atrial fibrillation.
阵发性心房颤动可能像慢性心房颤动一样是中风的一个危险因素。我们研究了平均血小板体积与阵发性心房颤动之间的关系，以确定阵发性心房颤动通过升高平均血小板体积对血栓形成状态的影响。平均血小板体积是血小板大小、功能和活化的一个标志物。平均血小板体积增加反映了活跃且较大的血小板，其比小血小板释放更多的血栓素A2。我们假设阵发性心房颤动患者的平均血小板体积升高。研究人群包括103例通过24小时动态心电图监测检测出阵发性心房颤动的连续患者以及87例动态心电图监测正常的对照个体。测量了平均血小板体积和炎症参数。收集了全面的临床和超声心动图数据。患有主动脉和二尖瓣狭窄、甲状腺功能亢进、甲状腺功能减退、恶性肿瘤、感染和妊娠的患者被排除在研究之外。阵发性心房颤动组和对照组患者的平均年龄分别为63±11岁和45±14岁（P<0.001）。阵发性心房颤动组有57例患者（55%）为男性，对照组有19例患者（21%）为男性（P<0.001）。与对照组相比，阵发性心房颤动组的平均血小板体积显著更高（分别为10.0±2.0fl和8.3±1.5fl；P<0.001）。阵发性心房颤动组的C反应蛋白（分别为18.5±28和3.8±2mg/l；P=0.004）和红细胞沉降率（分别为21±21和12±7mm/h；P=0.01）也更高。两组之间白细胞和血小板计数无差异。在多变量分析中，调整年龄和性别后，平均血小板体积升高与阵发性心房颤动的发生相关。我们的结果表明，阵发性心房颤动患者的炎症标志物如C反应蛋白和红细胞沉降率以及血小板大小和活性标志物平均血小板体积升高。
