Key result
Paroxysmal atrial fibrillation within 48 hours of onset was associated with significantly higher plasma tissue factor levels (268.63 vs. 170.21 pg/mL) and increased coagulation factor activities compared to healthy controls.
Why the study?
The intimate mechanisms leading to impaired coagulation and the timing of their activation in atrial fibrillation are unclear.
Case-Control (n=103)
No
Absolute Event Rate: 268.63% vs 170.21%
p-value: p=<0.001
Paroxysmal atrial fibrillation is associated with early activation of both intrinsic and extrinsic coagulation pathways within the first 6 hours of onset, suggesting a rapid shift toward hypercoagulability.
Early paroxysmal AF may signal need for prompt thromboembolic risk reassessment; leaves open whether immediate anticoagulation modifies outcomes.
Background: Atrial fibrillation (AF) is a hypercoagulable state. However, the intimate mechanisms leading to impaired coagulation and the timing of their activation are unclear. The aim of the study was to investigate the factors that initiate the coagulation cascade in the early hours (up to 48 h) of clinical manifestation of paroxysmal atrial fibrillation (PAF). Methods: Tissue factor (TF) level, coagulation activity of factor VII (FVIIa), factor XII (FXIIa) and factor XI (FXIa) were measured in plasma of 51 non-anticoagulated patients (26 men and 25 women, aged 59.84 ± 11.42 years) and 52 controls (26 men and 26 women, aged 59.50 ± 10.53 years) by enzyme-linked immunoassays and kinetic assays. Results: TF was higher in the PAF group (268.63 ± 90.62 pg/mL vs. 170.21 ± 66.19 pg/mL, P < 0.001) as well as FVIIa (170.82±59.39% vs. 95.17±37.90%, P < 0.001), FXIIa (218.31±84.04% vs. 148.41±53.94%, P < 0.001) and FXIa (178.41±55.94% vs. 111.75±37.33%, P < 0.001). Regression analysis showed that in the first 6 h of the disease, increase in time led to increase in FXIIa (r = 0.25, P < 0.05), FXIa (r = 0.75, P < 0.05), TF level (r = 0.25, P < 0.05) and FVIIa (r = 0.25, P < 0.05). Conclusion: Hemocoagulation changes were observed even < 6 h after the onset of the disease. They suggest that PAF has an early tendency for hypercoagulability, with the involvement of the intrinsic and extrinsic pathways of coagulation. Cardiol Res. 2020;11(1):22-32 doi: https://doi.org/10.14740/cr972 Â
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Negreva et al. (2020) conducted a case-control in Paroxysmal Atrial Fibrillation (n=103). Paroxysmal Atrial Fibrillation vs. Healthy controls was evaluated on Plasma tissue factor (TF) level (pg/mL) (p=<0.001). Paroxysmal atrial fibrillation within 48 hours of onset was associated with significantly higher plasma tissue factor levels (268.63 vs. 170.21 pg/mL) and increased coagulation factor activities compared to healthy controls.
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