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Association between P-selectin levels and left atrial blood stasis in patients with nonvalvular atrial fibrillation. Thromb Res 2018 Dec;172:4-8

Date

10/20/2018

Pubmed ID

30340092

Pubmed Central ID

PMC6309447

DOI

10.1016/j.thromres.2018.10.009

Scopus ID

2-s2.0-85054811446 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF.

METHODS: Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ± 14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ± 14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT).

RESULTS: The median soluble sPSL level was higher in NVAF cases compared to NSR controls [(interquartile range) 26 (20-32) ng/mL vs 22 (15-29) ng/mL, p = 0.0045]. Only NVAF patients with CHA2DS2-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels [32 (24-38) ng/mL] compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls.

CONCLUSIONS: There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA2DS2-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.

Author List

Wysokinski WE, Cohoon KP, Melduni RM, Mazur M, Ammash N, Munger T, Konik E, McLeod T, Gosk-Bierska I, McBane RD

Author

Kevin Cohoon DO Assistant Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Atrial Appendage
Atrial Fibrillation
Echocardiography
Female
Heart Atria
Humans
Male
Middle Aged
P-Selectin
Thrombosis