Noninvasive Surrogate Markers to Predict Thrombogenesis in Patients with Nonvalvular Atrial Fibrillation

• Takahashi Keiko

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Watanabe Ichiro

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Okumura Yasuo

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Iso Kazuki

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Kogawa Rikitake

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Nagashima Koichi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Kurokawa Sayaka

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Ohkubo Kimie

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Nakai Toshiko

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Kunimoto Satoshi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Hirayama Atsushi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

抄録

Background: Atrial fibrillation (AF) confers a substantial increase in the risk of stroke. While the CHADS2 score is considered a reliable predictor of stroke/thromboembolism risk in patients with AF, thromboembolism can occur even in AF patients with a low CHADS2 score (CHADS2 score = 0 or 1). We retrospectively assessed the relationships between left atrial appendage thrombus (LAAT) and patient characteristics, echocardiographic variables, and surrogate blood markers in patients with unanticoagulated AF, in order to determine whether thrombogenesis can be predicted in this patient population. Methods: The study group was comprised of 31 patients with unanticoagulated persistent non-valvular AF (NVAF) who underwent transthoracic echocardiography (TTE) and transesophageal echocardiography. Patients were divided into those with and without LAAT, and study variables were compared between the 2 groups. Results: LAAT was found in 14 patients. AF duration, left atrial diameter, left ventricular ejection fraction, left atrial appendage flow, β-thromboglobulin, platelet factor 4, prothrombin time, activated prothrombin time, fibrinogen, D-dimer, and antithrombin III levels did not differ between patients with and without LAAT. However, ANP and BNP levels were significantly higher in patients with LAAT (ANP ≥79 pg/ml, P = 0.03, BNP ≥120 pg/ml: P = 0.03). Moreover, patients with BNP ≥120 pg/ml exhibited an increased risk for LAAT (P = 0.03, odds ratio: 6.19), and patients with ANP ≥70 pg/ml in addition to BNP ≥120 pg/ml exhibited a further augmented risk for LAAT (P = 0.055, odds ratio: 8.75). Conclusions: In patients with unanticoagulated NVAF, a BNP level ≥120 pg/ml or an ANP level ≥70 pg/ml and BNP level ≥120 pg/ml could prove useful in predicting LAAT.

収録刊行物

• 日大医学雑誌

  日大医学雑誌 75 (2), 88-91, 2016

  日本大学医学会

キーワード

• atrial fibrillation
• left atrial thrombus
• atrial natriuretic peptide
• brain natriuretic peptide

詳細情報

• CRID: 1390001206431786112
• NII論文ID: 130005165532
• NII書誌ID: AN0018408X
• DOI: 10.4264/numa.75.2_88
• ISSN: 18840779
• ISSN: 00290424
• NDL書誌ID: 027345412
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I027345412
• Web Site: https://www.jstage.jst.go.jp/article/numa/75/2/75_88/_pdf
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可