Key result
Oral anticoagulant therapy with warfarin, apixaban, or rivaroxaban did not normalize thrombotic biomarkers, which remained significantly elevated in patients with atrial fibrillation (P<.05).
Why the study?
Does oral anticoagulant therapy reduce thrombotic biomarkers in patients with atrial fibrillation prior to ablation surgery?
Observational (n=30)
Does oral anticoagulant therapy reduce thrombotic biomarkers in patients with atrial fibrillation prior to ablation surgery?
Prothrombotic biomarkers remain elevated in patients with atrial fibrillation despite treatment with traditional or newer oral anticoagulants.
Residual risk consideration warranted pre-ablation in anticoagulated AF; leaves open optimal strategies to address elevated biomarkers.
The aim of this study was to examine the effect of the traditional oral anticoagulant, warfarin (W), and new anticoagulants, apixaban (A) and rivaroxaban (R), on the level of thrombotic biomarkers in patients with atrial fibrillation (AF). Circulating plasma levels of von Willebrand factor (vWF), prothrombin fragment 1.2 (F1.2), microparticle tissue factor (MP-TF), and plasminogen activator inhibitor (PAI-1) were analyzed as potential markers of clot formation in 30 patients with AF prior to ablation surgery. Patients with AF were divided into 2 groups based on their usage (n = 21) and nonusage (n = 9) of any oral anticoagulant. Furthermore, those on anticoagulants were divided based on their use of newer (R and A, 16) or traditional (W, 4) anticoagulants. A statistical increase (P < .05) in the levels of vWF, MP-TF, and PAI-1 were seen in anticoagulated patients with AF, whereas F1.2 and PAI-1 were increased in nonanticoagulated patients with AF compared to normal. There was no statistical difference (P > .05) in levels of any thrombotic biomarker between patients treated with the traditional anticoagulant, W, and those treated with new anticoagulants, R and A. Our data suggest that, despite the use of traditional or newer anticoagulants, prothrombotic biomarkers are still generated at increased levels in patients with AF. Further studies to confirm these findings are warranted.
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Liles et al. (2016) conducted an observational in Atrial fibrillation (n=30). Oral anticoagulants (warfarin, apixaban, rivaroxaban) vs. No oral anticoagulant and normal controls was evaluated on Circulating plasma levels of von Willebrand factor (vWF), prothrombin fragment 1.2 (F1.2), microparticle tissue factor (MP-TF), and plasminogen activator inhibitor (PAI-1) (p=<.05). Oral anticoagulant therapy with warfarin, apixaban, or rivaroxaban did not normalize thrombotic biomarkers, which remained significantly elevated in patients with atrial fibrillation (P<.05).
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