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February 1, 2003StrokeOpen Access

Atrial Fibrillation and the Prothrombotic State in the Elderly

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Why the study?

Is atrial fibrillation associated with elevated prothrombotic plasma markers (vWf, sP-sel, fibrinogen) in the elderly?

Population

162 elderly participants with documented atrial fibrillation and 324 age- and sex-matched population…

Comparison

Presence of Atrial Fibrillation (AF) vs Age- and sex-matched population controls without…

Design

Case-control

Key result

Atrial fibrillation was positively associated with von Willebrand factor levels among women (OR 1.17; 95% CI 1.02-1.34 per 10-IU/dL increase), but not among men or with fibrinogen and sP-sel.

Authors

DCDwayne ConwayJHJan HeeringaDKDeirdre A.M. van der Kuip

Discussion

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Overview

May indicate sex-specific endothelial dysfunction in elderly women with AF; leaves open whether vWf predicts thromboembolic events.

Key Points

  • This study aims to explore the connection between atrial fibrillation (AF) and prothrombotic plasma markers in the elderly.
  • Matched case-control study with 162 elderly participants from the Rotterdam Study
  • Plasma markers vWf and sP-sel measured by ELISA; fibrinogen measured using the Clauss method
  • Conditional logistic regression analysis adjusted for potential confounders
  • No significant relationship found between fibrinogen (P=0.8) or sP-sel (P=0.6) and AF.
  • A significant positive relationship between vWf and AF present in women (OR, 1.17; 95% CI, 1.02 to 1.34) per 10-IU/dL increase.
  • No significant relationship between vWf and AF found among men (OR, 1.06; 95% CI, 0.96 to 1.17).

Study Design

Type

Case-Control (n=486)

Structured PICO

Is atrial fibrillation associated with elevated prothrombotic plasma markers (vWf, sP-sel, fibrinogen) in the elderly?

P
Population
162 elderly participants with documented atrial fibrillation (AF) and 324 age- and sex-matched population controls from the Rotterdam Study, mean age 78+/-8 years, 51% male.
I
Intervention
Presence of Atrial Fibrillation (AF)
C
Comparator
Age- and sex-matched population controls without AF
O
Outcome
Relationship between AF and 3 prothrombotic plasma markers: von Willebrand factor (vWf), soluble P-selectin (sP-sel), and fibrinogensurrogate

Main Result

Effect estimate: OR 1.17 (95% CI 1.02 to 1.34)

Atrial fibrillation is associated with elevated von Willebrand factor, a marker of endothelial dysfunction, particularly in elderly women, suggesting a sex-specific prothrombotic state.

Limitations

  • Longitudinal studies are needed to determine the relationship between these plasma markers and stroke risk.
  • Longitudinal studies are needed to determine the relationship between these plasma markers and stroke risk

Cite This Study

Conway et al. (2003) conducted a case-control in Atrial fibrillation (n=486). Atrial fibrillation (exposure) vs. Population controls without AF was evaluated on Association between AF and von Willebrand factor (vWf) level among women (per 10-IU/dL increase) (OR 1.17, 95% CI 1.02 to 1.34). Atrial fibrillation was positively associated with von Willebrand factor levels among women (OR 1.17; 95% CI 1.02-1.34 per 10-IU/dL increase), but not among men or with fibrinogen and sP-sel.

synapsesocial.com/papers/6a11d6ed8095bbd48eb4cab6https://doi.org/10.1161/01.str.0000051728.85133.32
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