Berge Trygve, Ulimoen Sara R, Enger Steve, Arnesen Harald, Seljeflot Ingebjørg, Tveit Arnljot
a Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital , Rud.
b Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål , Oslo.
Scand J Clin Lab Invest. 2013;73(4):326-33. doi: 10.3109/00365513.2013.780093. Epub 2013 Apr 16.
Atrial fibrillation (AF) is associated with inflammation and a prothrombotic state; however, it is still unclear whether this is independent of ageing and comorbidity. The objective of this study was to investigate the impact of AF on circulating levels of inflammatory and fibrinolytic markers in a 75-year-old general population.
All 75-year-old citizens in Asker and Baerum counties in Norway were invited to participate in a prevalence study of AF. Blood samples were collected from 63 subjects with AF and a gender-matched control group of 126 subjects in sinus rhythm. C-reactive protein (CRP), tumour necrosis factor α (TNFα), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), P-selectin, CD40 ligand, tissue plasminogen activator antigen (tPA ag), plasminogen activator inhibitor-1 (PAI-1), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase inhibitor 1 (TIMP-1) activity were analyzed using commercially available assays.
Subjects with AF had higher levels of IL-6 (median 3.07 pg/mL (interquartile range 2.11, 4.36) vs. 2.26 (1.70, 3.26); p = 0.002) and PAI-1 activity (12.9 U/mL (6.6, 17.1) vs. 9.0 (4.6, 14.0); p = 0.005). No difference was found for the other markers. The presence of AF was still significantly associated with higher levels of IL-6 and PAI-1 activity after adjusting for confounders (p = 0.028 and p = 0.007, respectively).
AF was independently associated with higher levels of IL-6 and PAI-1 activity. Thus, there is evidence of a proinflammatory state and reduced fibrinolysis also in this stable, out-of-hospital group of 75-year-old AF patients.
心房颤动（AF）与炎症和血栓前状态相关；然而，这是否独立于衰老和合并症仍不清楚。本研究的目的是调查AF对75岁普通人群循环炎症和纤溶标志物水平的影响。
邀请挪威阿斯克和拜鲁姆县所有75岁的公民参加AF患病率研究。从63例AF患者和126例窦性心律的性别匹配对照组中采集血样。使用市售检测方法分析C反应蛋白（CRP）、肿瘤坏死因子α（TNFα）、白细胞介素-6（IL-6）、单核细胞趋化蛋白-1（MCP-1）、P选择素、CD40配体、组织纤溶酶原激活物抗原（tPA ag）、纤溶酶原激活物抑制剂-1（PAI-1）、基质金属蛋白酶-9（MMP-9）和金属蛋白酶抑制剂1组织抑制剂（TIMP-1）活性。
AF患者的IL-6水平较高（中位数3.07 pg/mL（四分位间距2.11，4.36）对2.26（1.70，3.26）；p = 0.002）和PAI-1活性较高（12.9 U/mL（6.6，17.1）对9.0（4.6，14.0）；p = 0.005）。其他标志物未发现差异。在调整混杂因素后，AF的存在仍与较高的IL-6水平和PAI-1活性显著相关（分别为p = 0.028和p = 0.007）。
AF与较高的IL-6水平和PAI-1活性独立相关。因此，在这组稳定的75岁非住院AF患者中也有促炎状态和纤溶降低的证据。
