Sohara H, Amitani S, Kurose M, Miyahara K
Division of Cardiology, Shinkyo Hospital, Kagoshima, Japan.
J Am Coll Cardiol. 1997 Jan;29(1):106-12. doi: 10.1016/s0735-1097(96)00427-5.
To determine whether atrial fibrillation (AF) alone affects the fibrinocoagulation system, we examined the relation between fibrinocoagulation activity and duration of AF in patients with paroxysmal AF (PAF).
Patients with chronic AF are at higher risk for stroke and a hypercoagulative state. It is not clear whether this hypercoagulative state is attributable to AF alone or to the underlying disease. There are no reports on the fibrinocoagulation properties in PAF.
Fibrinocoagulation variables in 21 patients with PAF were measured during AF and 7 days after recovery of sinus rhythm. There were positive correlations between the duration of AF and beta-thromboglobulin, platelet factor 4, thrombin-antithrombin III complex and fibrinogen. These variables increased significantly 12 h after the occurrence of PAF; thus, patients were classified into two groups according to the duration of PAF: PAF-I group (< 12 h, n = 10), PAF-II group (> or = 12 h, n = 11). Nine age-matched, healthy subjects formed the control group.
Levels of beta-thromboglobulin and platelet factor 4 were significantly higher (p < 0.001) by two-way repeated measures analysis of variance (ANOVA), and thrombin-antithrombin III complex and fibrinogen levels tended to be but were not significantly higher (p = 0.06, ANOVA), in the PAF-II group than in the PAF-I group. There were no significant differences between groups in activated partial thromboplastin time, D-dimer or plasmin inhibitor complex.
These results indicate that AF itself enhances platelet aggregation and coagulation, which are influenced by the duration of AF. The acceleration of platelet activity and coagulability occurred 12 h after the occurrence of AF.
为了确定单纯房颤（AF）是否会影响纤维蛋白凝血系统，我们研究了阵发性房颤（PAF）患者的纤维蛋白凝血活性与房颤持续时间之间的关系。
慢性房颤患者发生中风和高凝状态的风险更高。目前尚不清楚这种高凝状态是仅归因于房颤还是潜在疾病。关于PAF患者的纤维蛋白凝血特性尚无报道。
对21例PAF患者在房颤期间及窦性心律恢复7天后的纤维蛋白凝血变量进行测量。房颤持续时间与β-血小板球蛋白、血小板因子4、凝血酶-抗凝血酶III复合物和纤维蛋白原之间存在正相关。这些变量在PAF发作后12小时显著增加；因此，根据PAF持续时间将患者分为两组：PAF-I组（<12小时，n = 10），PAF-II组（≥12小时，n = 11）。9名年龄匹配的健康受试者组成对照组。
通过双向重复测量方差分析（ANOVA），PAF-II组的β-血小板球蛋白和血小板因子4水平显著更高（p < 0.001），凝血酶-抗凝血酶III复合物和纤维蛋白原水平虽有升高趋势但无显著差异（p = 0.06，ANOVA），PAF-II组高于PAF-I组。活化部分凝血活酶时间、D-二聚体或纤溶酶抑制剂复合物在两组之间无显著差异。
这些结果表明房颤本身会增强血小板聚集和凝血，且受房颤持续时间的影响。血小板活性和凝血能力的加速在房颤发作后12小时出现。
