Key result
Increased expression of P-selectin on platelets and advanced age were associated with the number of foci of silent cerebral infarction in patients with atrial fibrillation.
Why the study?
Is increased P-selectin expression on platelets associated with silent cerebral infarction in patients with atrial fibrillation?
Case-Control (n=50)
Is increased P-selectin expression on platelets associated with silent cerebral infarction in patients with atrial fibrillation?
Atrial fibrillation is associated with reduced nitric oxide synthesis and increased platelet P-selectin expression, which correlates with an increased risk of silent cerebral infarction.
Answers are grounded in this paper and cite their sources.
Platelet P-selectin expression may signal higher silent infarct burden in AF; leaves open causality and need for prospective validation.
BACKGROUND: Platelet activation and decreased levels of nitrite and nitrate (NOx), stable end products of nitric oxide (NO), are reported in patients with atrial fibrillation (AF). We examined the time-course changes in plasma NOx levels and the expression of P-selectin on platelets after the onset of AF in a canine model and determined whether these parameters could be risk factors for silent cerebral infarction in patients with AF. METHODS AND RESULTS: AF was induced by rapid atrial pacing in the canine model of AF. Plasma NOx levels were significantly decreased and the levels of P-selectin on platelets and of neutrophil/platelet conjugates were significantly increased after the onset of AF in this model. The in vitro experiments demonstrated that the inhibition of NO synthesis increased the expression of P-selectin on platelets. Plasma NOx levels (19.7+/-2.4 versus 27.5+/-2.8 micromol/L) were significantly lower in 25 patients with AF compared with age- (+/-2 years) and sex-matched control subjects. Conversely, the levels of P-selectin on platelets (7.6+/-0.8% versus 4.8+/-0.7%) and of neutrophil/platelet conjugates (14.8+/-0.9% versus 8.1+/-0.6%) were significantly higher in patients with AF. Multiple regression analysis revealed that increased P-selectin on platelets and advanced age were associated with the number of foci of silent cerebral infarction. CONCLUSIONS: An irregular heart rate that is characteristic of AF appeared to blunt NO synthesis. The increased expression of P-selectin on platelets associated with the reduced NO levels was a risk factor for silent cerebral infarction in patients with AF.
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Minamino et al. (1998) conducted a case-control in Atrial Fibrillation (n=50). Atrial fibrillation vs. Age- and sex-matched control subjects was evaluated on Levels of P-selectin on platelets. Increased expression of P-selectin on platelets and advanced age were associated with the number of foci of silent cerebral infarction in patients with atrial fibrillation.
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