BACKGROUND The pathophysiological mechanism associated with the higher prothrombotic tendency in atrial fibrillation (AF) is complex and multifactorial. However, the role of prothrombotic markers in AF remains inconclusive. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating the association of coagulation activation, fibrinolytic, and endothelial function with occurrence of AF and clinical adverse events. A comprehensive subgroup analysis and meta-regression was performed to explore potential sources of heterogeneity. RESULTS A literature search of major databases retrieved 1703 studies. After screening, a total of 71 studies were identified. Pooled analysis showed the association of coagulation markers (D-dimer (weighted mean difference (WMD) =197.67 and p<0.001), fibrinogen (WMD=0.43 and p<0.001), prothrombin fragment 1-2 (WMD=0.53 and p<0.001), antithrombin III (WMD=23.90 and p=0.004), thrombin-antithrombin (WMD=5.47 and p=0.004));  fibrinolytic markers (tissue-type plasminogen activator (t-PA) (WMD=2.13 and p<0.001), plasminogen activator inhibitor (WMD=11.44 and p<0.001), fibrinopeptide-A (WMD=4.13 and p=0.01)); and  endothelial markers (von Willebrand factor (WMD=27.01 and p<0.001) and soluble thrombomodulin (WMD=3.92 and p<0.001)) with AF. CONCLUSIONS The levels of coagulation, fibrinolytic, and endothelial markers have been reported to be significantly higher in AF patients than in SR patients.

Predictive Role of Coagulation, Fibrinolytic, and Endothelial Markers in Patients with Atrial Fibrillation, Stroke, and Thromboembolism: A Meta-Analysis, Meta-Regression, and Systematic Review / Weymann, Alexander; Sabashnikov, Anton; Ali-Hasan-Al-Saegh, Sadeq; Popov, Aron-Frederik; Jalil Mirhosseini, Seyed; Baker, William L; Lotfaliani, Mohammadreza; Liu, Tong; Dehghan, Hamidreza; Yavuz, Senol; de Oliveira Sá, Michel Pompeu Barros; Jang, Jae-Sik; Zeriouh, Mohamed; Meng, Lei; D'Ascenzo, Fabrizio; Deshmukh, Abhishek J; Biondi-Zoccai, Giuseppe; Dohmen, Pascal M; Calkins, Hugh; Cardiac Surgery And Cardiology-Group Imcsc-Group, Integrated Meta-Analysis Of Cardiac. - In: MEDICAL SCIENCE MONITOR BASIC RESEARCH. - ISSN 2325-4416. - 23:(2017), pp. 97-140. [10.12659/MSMBR.902558]

Predictive Role of Coagulation, Fibrinolytic, and Endothelial Markers in Patients with Atrial Fibrillation, Stroke, and Thromboembolism: A Meta-Analysis, Meta-Regression, and Systematic Review

Biondi-Zoccai, Giuseppe;
2017

Abstract

BACKGROUND The pathophysiological mechanism associated with the higher prothrombotic tendency in atrial fibrillation (AF) is complex and multifactorial. However, the role of prothrombotic markers in AF remains inconclusive. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating the association of coagulation activation, fibrinolytic, and endothelial function with occurrence of AF and clinical adverse events. A comprehensive subgroup analysis and meta-regression was performed to explore potential sources of heterogeneity. RESULTS A literature search of major databases retrieved 1703 studies. After screening, a total of 71 studies were identified. Pooled analysis showed the association of coagulation markers (D-dimer (weighted mean difference (WMD) =197.67 and p<0.001), fibrinogen (WMD=0.43 and p<0.001), prothrombin fragment 1-2 (WMD=0.53 and p<0.001), antithrombin III (WMD=23.90 and p=0.004), thrombin-antithrombin (WMD=5.47 and p=0.004));  fibrinolytic markers (tissue-type plasminogen activator (t-PA) (WMD=2.13 and p<0.001), plasminogen activator inhibitor (WMD=11.44 and p<0.001), fibrinopeptide-A (WMD=4.13 and p=0.01)); and  endothelial markers (von Willebrand factor (WMD=27.01 and p<0.001) and soluble thrombomodulin (WMD=3.92 and p<0.001)) with AF. CONCLUSIONS The levels of coagulation, fibrinolytic, and endothelial markers have been reported to be significantly higher in AF patients than in SR patients.
2017
Atrial Fibrillation; Blood Coagulation Disorders; Fibrinolysis; Atrial Fibrillation; Biomarkers; Blood Coagulation Factors; Fibrin Fibrinogen Degradation Products; Fibrinolytic Agents; Humans; Stroke; Thromboembolism; Tissue Plasminogen Activator
01 Pubblicazione su rivista::01a Articolo in rivista
Predictive Role of Coagulation, Fibrinolytic, and Endothelial Markers in Patients with Atrial Fibrillation, Stroke, and Thromboembolism: A Meta-Analysis, Meta-Regression, and Systematic Review / Weymann, Alexander; Sabashnikov, Anton; Ali-Hasan-Al-Saegh, Sadeq; Popov, Aron-Frederik; Jalil Mirhosseini, Seyed; Baker, William L; Lotfaliani, Mohammadreza; Liu, Tong; Dehghan, Hamidreza; Yavuz, Senol; de Oliveira Sá, Michel Pompeu Barros; Jang, Jae-Sik; Zeriouh, Mohamed; Meng, Lei; D'Ascenzo, Fabrizio; Deshmukh, Abhishek J; Biondi-Zoccai, Giuseppe; Dohmen, Pascal M; Calkins, Hugh; Cardiac Surgery And Cardiology-Group Imcsc-Group, Integrated Meta-Analysis Of Cardiac. - In: MEDICAL SCIENCE MONITOR BASIC RESEARCH. - ISSN 2325-4416. - 23:(2017), pp. 97-140. [10.12659/MSMBR.902558]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1085898
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