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Minerva Cardioangiologica 2020 Jul 10

DOI: 10.23736/S0026-4725.20.05209-3


language: English

Paroxysmal atrial fibrillation is associated with early coagulation activity regardless of risk factors for embolism

Mariya N. NEGREVA 1 , Krasimira S. PRODANOVA 2, Katerina D. VITLIANOVA 3

1 Section of Cardiology, Department of Cardiology, University Hospital St. Marina, Varna, Bulgaria; 2 Section of Mathematical Analysis and Differential Equations, Faculty of Applied Mathematics and Computer Science, Technical University of Sofia, Sofia, Bulgaria; 3 Section of Cardiology, Department of Cardiology, Second City Hospital of Sofia, Sofia, Bulgaria


BACKGROUND: Paroxysmal atrial fibrillation (PAF) is associated with an increased incidence of embolic events, even in patients with no embologenic risk factors. This fact raises the question for the hypercoagulability in PAF as a state closely related to the arrhythmia itself, independent of other well established embologenic risk factors. The scarce data on that topic predisposed our aim that was to study coagulation activity in the early hours (up to the twenty-fourth hour) of the disease.
METHODS: 51 non-anticoagulated patients (26 men, 25 women; mean age 59.84±1.60 years) and 52 controls (26 men, 26 women; mean age 59.50±1.46 years) were consequently selected for the study. Plasma coagulation activity of factor II (FII), factor V (FV) and factor X (FX) was examined.
RESULTS: In the PAF group, there was a higher activity of FII (167.81%±9.12% vs 100.43%±5.77%, p<0.001), FV (198.47%±10.88% vs 121.53%±4.79%, p<0.001) and FX (193.20%±11.85 vs 116.20%±5.86, p<0.001). The deviations were independent of age, sex, body mass index, presence of hypertension and CHA2DS2-VASc risk score (p>0.05). PAF duration was a significant predictor of FII activity (r=0.83, p<0.001) but no correlation was established between FV and FX activity and the arrhythmia duration (r=0.10, p>0.05; r=0.11, p>0.05, respectively).
CONCLUSIONS: We established high coagulation activity during the first twenty-four hours of PAF. The observed deviations in the studied parameters give us reason to consider PAF a procoagulant state independent of the well established prothrombotic risk factors, even in its early clinical manifestation.

KEY WORDS: Paroxysmal atrial fibrillation; Risk factor; Embolism

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