Cardiovascular Department, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, No. 96, Dongchuan Road, 510080 Guangzhou, Peoples Republic of China.
Europace. 2011 Jan;13(1):31-6. doi: 10.1093/europace/euq346. Epub 2010 Sep 18.
A prothrombotic state with elevated levels of soluble P-selectin (sP-sel), fibrinogen, von Willebrand factor (vWf), and other haemostatic indices has been reported in some patients with atrial fibrillation (AF). Whether these changes are due to AF itself or coexistent cardiovascular diseases remains a matter of debate. Therefore, in the present study, the differences in plasma levels of sP-sel, fibrinogen, and vWf between patients with idiopathic/lone AF and sex-, age-, and risk factor-matched controls were investigated to determine whether AF itself might be associated with a hypercoagulable state.
Ninety consecutive patients (63 males, 54.1 ± 10.1 years) with idiopathic AF were studied, 60 (43 males, 48.8 ± 7.5 years) of whom were diagnosed as lone AF. Plasma sP-sel and vWf were measured by enzyme-linked immunosorbent assay. Plasma fibrinogen was measured by chromometry. These indices in AF patients were compared with those in sex-, age- and risk factor-matched controls. Compared with the controls, patients with idiopathic AF had higher levels of sP-sel (AF vs. control: 33.4 ± 7.4 vs. 29.2 ± 6.5 ng/mL, P < 0.001) and fibrinogen (AF vs. control: 3.3 ± 0.9 vs. 3.0 ± 0.6 g/L, P = 0.02), but not vWf, whether with the adjustment of covariates or not. As for those < 60 years, between lone AF and age-matched controls, significant difference existed in the levels of sP-sel (AF vs. control: 34.5 ± 7.3 vs. 30.2 ± 7.3 ng/mL, P = 0.002), but not in those of fibrinogen and vWf, whether with the adjustment of covariates or not.
Both platelet activation and abnormal changes in coagulation were suggested in idiopathic AF and a platelet activation state in lone AF. This supports the notion that AF per se contributes to a state of hypercoagulation.
已有研究报道，一些心房颤动（AF）患者存在血栓形成状态，表现为可溶性 P 选择素（sP-sel）、纤维蛋白原、血管性血友病因子（vWf）和其他止血指标水平升高。这些变化是由于 AF 本身还是并存的心血管疾病仍存在争议。因此，本研究旨在探讨特发性/孤立性 AF 患者与性别、年龄和危险因素相匹配的对照组之间血浆 sP-sel、纤维蛋白原和 vWf 水平的差异，以确定 AF 本身是否与高凝状态相关。
本研究连续纳入 90 例特发性 AF 患者（63 例男性，年龄 54.1±10.1 岁），其中 60 例（43 例男性，年龄 48.8±7.5 岁）被诊断为孤立性 AF。采用酶联免疫吸附试验测定血浆 sP-sel 和 vWf，比色法测定血浆纤维蛋白原。将 AF 患者的这些指标与性别、年龄和危险因素相匹配的对照组进行比较。与对照组相比，特发性 AF 患者的 sP-sel（AF 组 vs. 对照组：33.4±7.4 vs. 29.2±6.5 ng/mL，P<0.001）和纤维蛋白原（AF 组 vs. 对照组：3.3±0.9 vs. 3.0±0.6 g/L，P=0.02）水平更高，但 vWf 水平没有差异，无论是否调整协变量。对于年龄<60 岁的患者，与年龄匹配的对照组相比，孤立性 AF 患者的 sP-sel 水平（AF 组 vs. 对照组：34.5±7.3 vs. 30.2±7.3 ng/mL，P=0.002）存在显著差异，但纤维蛋白原和 vWf 水平没有差异，无论是否调整协变量。
特发性 AF 中存在血小板激活和凝血异常改变，孤立性 AF 中存在血小板激活状态。这支持了 AF 本身导致高凝状态的观点。
